NPIMap

Individual provider Active NPI

Cassidy Marie Lane

  • Student in an Organized Health Care Education/Training Program
  • Fort Worth, TX
National Provider Identifier
1356046056
Registry record updated Feb 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1500 S Main St
Fort Worth, TX 76104-4917
Phone
(817) 702-3431
NPI assigned
Apr 3, 2023
Last updated
Feb 16, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X TX Primary
Emergency Medicine Physician 207P00000X V3362 TX

Addresses

Primary practice location

1500 S Main St
Fort Worth, TX 76104-4917

Mailing address

10301 Bridgetown LN
Crowley, TX 76036-3998
Phone (903) 312-1686

Other names 1

  • Cassidy Marie Doke Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, SC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250124002888 TX Practitioner - Emergency Medicine 9234668948 Reassigns benefits to 2 organizations
I20260429002121 SC Practitioner - Emergency Medicine 9234668948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Conway Hospital Emergency Professional ServicesGroup PAC ID 2163516980, 20 clinicians
Primary Health Physicians PLLCGroup PAC ID 7810237740, 240 clinicians

Practice addresses (Care Compare)

300 Singleton Ridge Rd
Conway, SC 29526-9142
Phone (843) 347-7111

7400 McCart Ave
Fort Worth, TX 76133-7270
Phone (817) 294-1651

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
V3362TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Emergency Services Physician Group PA Emergency Medicine CurrentSince Jan 1, 2025 Accepting new patients
Primary Health Physicians, PLLC CurrentSince Apr 21, 2025 Accepting new patients

Locations

2310 W University Dr
#1500
Denton, TX 76201
Phone (940) 220-5901

1500 S Main St
Ft Worth, TX 76104
Phone (817) 921-3431

1500 S Main St
Fl 1
Ft Worth, TX 76104
Phone (817) 702-1451

1575 S Main St
Ft Worth, TX 76104
Phone (817) 702-8828

104 S Main St
Keller, TX 76248
Phone (214) 295-9385

377 W Campbell Rd
Ste 100
Richardson, TX 75080
Phone (469) 232-2945

Organizations & group practices 4

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.

Hospital & facility affiliations 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739664000000",
    "number": "1356046056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10301 BRIDGETOWN LN",
            "city": "CROWLEY",
            "state": "TX",
            "postal_code": "760363998",
            "telephone_number": "903-312-1686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S MAIN ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761044917",
            "telephone_number": "817-702-3431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANE",
        "first_name": "CASSIDY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-03",
        "last_updated": "2025-02-16",
        "certification_date": "2025-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "V3362",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "DOKE",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.