Individual provider Active NPI

Peggy P Cassada, ANP

  • Adult Health Nurse Practitioner
  • Danville, VA
National Provider Identifier
1093837395
Registry record updated Jun 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0024059075 Issued in VA
Practice address
705 Piney Forest Rd
Danville, VA 24540-2860
Phone
(434) 710-4210
NPI assigned
Apr 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 0024059075 VA Primary

Addresses

Primary practice location

705 Piney Forest Rd
Danville, VA 24540-2860

Mailing address

705 Piney Forest Rd
Danville, VA 24540-2860
Phone (434) 710-4210

Other identifiers 2

IdentifierTypeStateIssuer
1093837395MedicaidVA
0024059075OtherVAANP LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181108000380 VA Order and Referring Only - Nurse Practitioner 0446144471

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Paradigm Health, LLC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1093837395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402860",
            "telephone_number": "434-710-4210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 PINEY FOREST RD",
            "city": "DANVILLE",
            "state": "VA",
            "postal_code": "245402860",
            "telephone_number": "434-710-4210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSADA",
        "first_name": "PEGGY",
        "middle_name": "P",
        "credential": "ANP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024059075",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093837395",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANP LICENSE",
            "identifier": "0024059075",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Danville, VA

Sources for this page

Verify at the official NPI Registry.