Individual provider Active NPI

Cassie L Landrum

  • Physical Therapist
  • Lexington, KY
National Provider Identifier
1255392973
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
004801 Issued in KY
Practice address
1792 Alysheba Way
Lexington, KY 40509-2288
Phone
(859) 293-6133
NPI assigned
Mar 31, 2006
Last updated
Aug 31, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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 004801 KY Primary

Addresses

Primary practice location

1792 Alysheba Way
Lexington, KY 40509-2288

Mailing address

1792 Alysheba Way
Lexington, KY 40509-2288
Phone (859) 293-6133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051005001029 KY Practitioner - Physical Therapist in Private Practice 9638104920 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Kentucky College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

71 Orphanage Rd
Fort Mitchell, KY 41017-3006
Phone (859) 331-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004801KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Redwood School & Rehabilitation Center, Inc. Physical Therapist CurrentSince Nov 20, 2020 Accepting new patients
Redwood School and Rehabilitation Center, Inc. CurrentSince Nov 20, 2020 Accepting new patients

Locations

7627 Ewing Blvd
Florence, KY 41042
Phone (859) 283-1500

71 Orphanage Rd
Ft Mitchell, KY 41017
Phone (859) 331-0880

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1255392973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1792 ALYSHEBA WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092288",
            "telephone_number": "859-293-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1792 ALYSHEBA WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405092288",
            "telephone_number": "859-293-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDRUM",
        "first_name": "CASSIE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-31",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "004801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; 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.