Kourtney Marie Cassidy

Primary specialty

Critical Care Neonatal Nurse PractitionerTaxonomy code 363LN0005X

License

SP029866 Issued in PA

Practice address

130 S Bryn Mawr Ave
Bryn Mawr, PA 19010-3121

Phone

(484) 337-3000

NPI assigned

May 31, 2024

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1717113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1245070614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HILLCREST DR",
            "city": "DELMONT",
            "state": "PA",
            "postal_code": "156261616",
            "telephone_number": "412-965-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 S BRYN MAWR AVE",
            "city": "BRYN MAWR",
            "state": "PA",
            "postal_code": "190103121",
            "telephone_number": "484-337-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "KOURTNEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-31",
        "last_updated": "2024-05-31",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0005X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal, Critical Care",
            "state": "PA",
            "license": "SP029866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James B. Carty, M.D.
• Caryl Technologies, LLC
• Eileen Casaccio, PSY.D.
• Thomas James Casey, M.D.
• Nicole Marie Cash, MSW, LCSW
• Heather Lee Cates, CNM
• Catherine M. Foote, PC
• Richard Alan Centafont, R.PH.
• Center for Anxiety & Behavior Therapy
• Center for Interventional Pain Spine LLC

• Critical Care Neonatal Nurse Practitioner in Bryn Mawr, PA
• Providers in Bryn Mawr, PA by specialty
• Critical Care Neonatal Nurse Practitioner in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 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.