Shantina Jenae Cassidy, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F08190124 Issued in NC

Practice address

1101 Carolina Street
Greensboro, NC 27401-1318

Phone

(336) 333-6860

NPI assigned

Oct 3, 2019

Last updated

May 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Shantina Jenae Thomas Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: shantina.cassidy.1@18731.direct.athenahealth.com
• Direct secure messaging: sjthomas@adsyes.org

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

{
    "created_epoch": "1570060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1144861840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 CAROLINA STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "27401",
            "telephone_number": "336-333-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 CAROLINA STREET",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011318",
            "telephone_number": "336-333-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "SHANTINA",
        "middle_name": "JENAE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-03",
        "last_updated": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "F08190124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sjthomas@adsyes.org",
            "affiliation": "N",
            "address_1": "1101 Carolina St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "SHANTINA",
            "last_name": "THOMAS",
            "middle_name": "JENAE",
            "prefix": "MS.",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Cassandra Hoskins LPC
• Kirstin Cassell, LCSW, LCAS
• Coley Cassiano, MD
• Hayley Cullen Cassiano, MA, CCC-SLP
• Nathan D Cassidy, MA, LPC, LCAS, NCC
• Sidney Cassidy
• Lori Castello
• Savannah Castillo, BCBA
• Christopher Brandon Castor, DDS
• Karla Castro Caraballo

• Family Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.