Coley Cassiano, MD
Individual provider Active NPI Family Medicine Physician · Greensboro, NC
NPI 1336218296 · NPPES record last updated Feb 20, 2008
Key facts
- NPI
- 1336218296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 21255 (NC)
- Practice address
- 301 E Wendover Ave
Suite 215
Greensboro, NC 27401-1230 - Phone
- (336) 379-1156
- Fax
- (336) 370-0442
- NPI assigned
- Nov 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eagle Physicians and Associates PA | Past | Accepting new patients | |
| Eagle Physicians and Associates PA | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 21255 | NC | Yes |
Addresses
Primary practice location
301 E Wendover Ave
Suite 215
Greensboro, NC 27401-1230
Mailing address
PO Box 14883
Greensboro, NC 27415-4883
Phone (336) 379-1156
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21929 | Other | NC | MEDCOST |
| 21592 | Other | NC | BCBS OF NC |
| 880 | Other | NC | PARTNERS MEDICARE |
| 8921592 | Medicaid | NC |
Other providers in Greensboro, NC
- Scott William Cashion VI
- Craig Scott Cashwell
- Tanya Joy Cass
- Cassandra Hoskins LPC
- Kirstin Cassell
- Hayley Cullen Cassiano
- Nathan D Cassidy
- Shantina Jenae Cassidy
- Sidney Cassidy
- Lori Castello
All providers in Greensboro, NC · Family Medicine Physician in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.