Active NPI
Tonja A Cassell, CFM
- Specialist
- Easley, SC
National Provider Identifier
1104140524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- C36260
- Practice address
- 1661 E Main St
Easley, SC 29640-3791 - Phone
- (864) 859-4709
- Fax
- (864) 855-9331
- NPI assigned
- Mar 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | C36260 | SC | Primary |
Addresses
Primary practice location
1661 E Main St
Easley, SC 29640-3791
Mailing address
1661 E Main St
Easley, SC 29640-3791
Phone (864) 859-4709
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C36260 | Other | SC | BOC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C36260 | SC | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1268611200000",
"number": "1104140524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1661 E MAIN ST",
"city": "EASLEY",
"state": "SC",
"postal_code": "296403791",
"telephone_number": "864-859-4709",
"fax_number": "864-855-9331"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1661 E MAIN ST",
"city": "EASLEY",
"state": "SC",
"postal_code": "296403791",
"telephone_number": "864-859-4709",
"fax_number": "864-855-9331"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CASSELL",
"first_name": "TONJA",
"middle_name": "A",
"credential": "CFM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-15",
"last_updated": "2010-03-15",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "SC",
"license": "C36260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOC",
"identifier": "C36260",
"state": "SC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Easley, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.