Active NPI
Kassidy D Kasperski, DC
- Chiropractor
- South Portland, ME
National Provider Identifier
1164037602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CR2674
- Practice address
- 210 Western Ave
South Portland, ME 04106-2424 - Phone
- (207) 775-7468
- NPI assigned
- Sep 11, 2020
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CR2674 | ME | Primary |
Addresses
Primary practice location
210 Western Ave
South Portland, ME 04106-2424
Mailing address
210 Western Ave
South Portland, ME 04106-2424
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CR2674 | ME | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Potential PLLC | Chiropractor | Current | Accepting new patients |
Locations
210 Western Ave
Ste 300
South Portland, ME 04106
Phone (207) 775-7468
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": "1599782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1599782400000",
"number": "1164037602",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 WESTERN AVE",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062424"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 WESTERN AVE",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062424",
"telephone_number": "207-775-7468"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KASPERSKI",
"first_name": "KASSIDY",
"middle_name": "D",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-09-11",
"last_updated": "2020-09-11",
"certification_date": "2020-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "ME",
"license": "CR2674",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.