Cassala Ward, MSN, RN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Charleston, MS
NPI 1134596919 · NPPES record last updated May 2, 2017
Key facts
- NPI
- 1134596919
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- R858468 (MS)
- Practice address
- 401 S Church St
Charleston, MS 38921-2257 - Phone
- (662) 647-5816
- NPI assigned
- Aug 27, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20171211000673 | MS | Practitioner - Nurse Practitioner | 0941568455 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing, Nurse Practitioner, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R858468 | MS | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fast Pace Mississippi, PLLC | Current |
Accepting new patients | |
| Grenada Emergency Group, LLC | Current |
Accepting new patients | |
| Fast Pace Mississippi, PLLC | Family | Current |
Accepting new patients |
| Yazoo Emergency Group, LLC | Current |
Accepting new patients | |
| Truhealth, LLC | Current |
Accepting new patients | |
| Tallahatchie General Hospital | Past |
Accepting new patients |
Locations
115 Highway 16 W
Carthage, MS 39051
Phone (601) 298-3101
700 Sunset Dr
Grenada, MS 38901
Phone (662) 307-2884
1966 Hill Dr
Grenada, MS 38901
Phone (662) 226-2442
960 Avent Dr
Grenada, MS 38901
Phone (662) 227-7000
239 Bowling Green Rd
Lexington, MS 39095
Phone (662) 834-1321
517 City Ave S
Ripley, MS 38663
Phone (662) 587-8206
823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261
925 Calhoun Ave
Yazoo City, MS 39194
Phone (662) 746-6651
1971 Tennessee Ave N
Parsons, TN 38363
Phone (731) 614-1424
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R858468 | MS | Yes |
Addresses
Primary practice location
401 S Church St
Charleston, MS 38921-2257
Mailing address
PO Box 27
Charleston, MS 38921-0027
Phone (662) 647-5816
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 06382561 | Medicaid | MS |
Other providers in Charleston, MS
- Tallahatchie General Hospital and Extended Care Facility
- Tallahatchie General Hospital Medical Foundation
- Jennifer Ann Taylor
- Sammie M Tellis
- The Pharmacy of Charleston
- Wiggins Family Dental, PLLC
- Kyle Wiggins
- James Oscar Wilde Jr.
- Audrey Leann Williamson
- Wolfe Family Medical Clinic PLLC
All providers in Charleston, MS · Family Nurse Practitioner in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 2, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.