Active NPI
Cassandra Connell
- Licensed Practical Nurse
- Salem, OR
National Provider Identifier
1295193365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- 201330180LPN
- Practice address
- 3871 Fairview Industrial Dr SE
Salem, OR 97302-1180 - Phone
- (503) 391-9762
- NPI assigned
- Feb 4, 2016
- 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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 201330180LPN | OR | Primary |
Addresses
Primary practice location
3871 Fairview Industrial Dr SE
Salem, OR 97302-1180
Mailing address
3871 Fairview Industrial Dr SE
Salem, OR 97302-1180
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 201330180LPN | OR | MD | Licensed Practical Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Willamette Valley Treatment Center | Licensed Practical Nurse | Past | Accepting new patients |
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.
-
- Licensed Practical Nurse
- Salem, OR
- NPI 1730636762
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1454544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454544000000",
"number": "1295193365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3871 FAIRVIEW INDUSTRIAL DR SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973021180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3871 FAIRVIEW INDUSTRIAL DR SE",
"city": "SALEM",
"state": "OR",
"postal_code": "973021180",
"telephone_number": "503-391-9762"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNELL",
"first_name": "CASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-02-04",
"last_updated": "2016-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OR",
"license": "201330180LPN",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Salem, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.