Individual provider Active NPI

Cassidy Marie Anderson, DC

  • Sports Physician Chiropractor
  • Long Beach, CA
National Provider Identifier
1316698012
Registry record updated Apr 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
DC36221 Issued in CA
Practice address
6324 E Pacific Coast Hwy Ste C
Long Beach, CA 90803-4841
Phone
(562) 493-5600
NPI assigned
Jan 13, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X DC36221 CA Primary

Addresses

Primary practice location

6324 E Pacific Coast Hwy Ste C
Long Beach, CA 90803-4841

Mailing address

6324 E Pacific Coast Hwy Ste C
Long Beach, CA 90803-4841
Phone (562) 493-5600

Other names 1

  • Dr. Cassidy Marie Brown Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220407000387 CA Practitioner - Chiropractic 8022404680 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloch Chiropractic Wellness and Sports Medicine PCGroup PAC ID 5193948792, 4 clinicians

Practice addresses (Care Compare)

6324 E Pacific Coast Hwy
Suite C
Long Beach, CA 90803-4840
Phone (562) 493-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC36221CAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bloch Chiropractic Wellness and Sports Medicine PC CurrentSince Feb 1, 2022 Accepting new patients

Locations

6324 E Pacific Coast Hwy
Ste C
Long Beach, CA 90803
Phone (562) 493-5600

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": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1316698012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6324 E PACIFIC COAST HWY STE C",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034841",
            "telephone_number": "562-493-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6324 E PACIFIC COAST HWY STE C",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908034841",
            "telephone_number": "562-493-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "CASSIDY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "CA",
            "license": "DC36221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "BROWN",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.