Individual provider Active NPI

Cassidy Porter, DPT

  • Physical Therapist
  • Pelham, AL
National Provider Identifier
1245093764
Registry record updated Feb 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH11705 Issued in AL
Practice address
3569 Pelham Pkwy Ste 7
Pelham, AL 35124-2033
Phone
(205) 664-8404
NPI assigned
Feb 6, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH11705 AL Primary

Addresses

Primary practice location

3569 Pelham Pkwy Ste 7
Pelham, AL 35124-2033

Mailing address

2823 Greystone Commercial Blvd
Hoover, AL 35242-2660
Phone (205) 745-3660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240222002469 AL Practitioner - Physical Therapist in Private Practice 9638513237 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therapy South Pelham, LLCGroup PAC ID 3173523222, 9 clinicians

Practice addresses (Care Compare)

3569 Pelham Pkwy
Suite 7
Pelham, AL 35124-2033
Phone (205) 664-8404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH11705ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy South Pelham, LLC Physical Therapist CurrentSince Jan 31, 2024 Accepting new patients

Locations

2823 Greystone Commercial Blvd
Hoover, AL 35242
Phone (205) 408-1713

3569 Pelham Pkwy
Ste 7
Pelham, AL 35124
Phone (205) 664-8404

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": "1707177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707177600000",
    "number": "1245093764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GREYSTONE COMMERCIAL BLVD",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352422660",
            "telephone_number": "205-745-3660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3569 PELHAM PKWY STE 7",
            "city": "PELHAM",
            "state": "AL",
            "postal_code": "351242033",
            "telephone_number": "205-664-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "CASSIDY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-06",
        "last_updated": "2024-02-06",
        "certification_date": "2024-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH11705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.