Cassandara M Shockley, APRN, BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

097006513N1 Issued in OR

Practice address

9900 Bren Road East
Mail Route MN 008-B213
Minnetonka, MN 55343

Phone

(541) 405-3646

NPI assigned

Feb 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Firstcare Medical Foundation

  dba Samaritan Medical Clinics

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498
  NPD (past)

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1184768137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40580 MOHAWK RIVER RD",
            "city": "MARCOLA",
            "state": "OR",
            "postal_code": "974549709",
            "telephone_number": "541-405-3646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN ROAD EAST",
            "address_2": "MAIL ROUTE MN 008-B213",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "55343",
            "telephone_number": "541-405-3646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3355 RiverBend Dr., Ste 500",
            "address_2": "Eugene Gastroenterology Consultants, P.C.",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "OR",
            "postal_code": "974778800",
            "country_code": "US",
            "telephone_number": "541-868-9500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHOCKLEY",
        "first_name": "CASSANDARA",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "APRN, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "097006513N1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shift Limited Liability Company (Shift Mental Health)
• Eaman Shire
• Grace A Shirley, ARNP
• Elliot Shively
• Stephanie Lynne Shively, PH.D., M.A.
• Nichole Short
• Kaitlyn Rose Shoults, M.S., CCC-SLP
• Brian Shragg, D.D.S
• Shree Revenue Management
• Emily Shultz

• Family Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.

Verify at the official NPI Registry.