Cassandra Amos- Johnson, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

902422 Issued in MS

Practice address

503 Silver Cross Dr
Brookhaven, MS 39601-2388

Phone

(601) 833-2361

NPI assigned

Dec 11, 2017

Last updated

Sep 21, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Cassandra Sharonette Walters Former name

Medicare fee-for-service enrollment

Enrolled in MS, LA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cassandra.walters.1@19675.direct.athenahealth.com

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.

• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Ripley, MS
  • NPI 1447769559

  Family

  Medicare reassignment NPD
• Heal All Wound Care LLC

  • Adult Health Nurse Practitioner
  • Flowood, MS
  • NPI 1093554982

  LA

  Medicare reassignment NPD
• MDB Care Management LLC

  • Primary Care Nurse Practitioner
  • Flowood, MS
  • NPI 1144925272
  Medicare reassignment NPD
• Mississippi Hma Hospitalists, LLC

  • Hospitalist Physician
  • Jackson, MS
  • NPI 1154608883
  Medicare reassignment NPD
• Southeastern Transitional Care Management Services

  • Family Medicine Physician
  • Flowood, MS
  • NPI 1831807825

  LA

  Medicare reassignment NPD
• Uppal Medical Center LLC

  • Rural Health Clinic/Center
  • Greenville, MS
  • NPI 1558927905
  Medicare reassignment NPD
• MDB Behavioral Health Services LLC

  dba Complete Care Rural Health Clinic

  • Rural Health Clinic/Center
  • Vicksburg, MS
  • NPI 1669835310
  Medicare reassignment
• Minor Med Care, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1407968738
  Medicare reassignment
• Southern Medical Consultants LLC

  • Primary Care Nurse Practitioner
  • Ridgeland, MS
  • NPI 1215396577
  Medicare reassignment
• Louisiana Health Care Practitioners LLC

  dba Mansura Family Clinic

  • Rural Health Clinic/Center
  • Mansura, LA
  • NPI 1811065220
  Medicare reassignment
• Fast Pace Mississippi, PLLC

  • Rural Health Clinic/Center
  • Kosciusko, MS
  • NPI 1851050579
  NPD
• Milestone Primary Care House Calls, LLC

  • Nurse Practitioner
  • Jackson, MS
  • NPI 1801447693
  NPD

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632182400000",
    "number": "1356856561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ROWAN OAK PL",
            "city": "TERRY",
            "state": "MS",
            "postal_code": "391707809",
            "telephone_number": "601-540-8260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 SILVER CROSS DR",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396012388",
            "telephone_number": "601-833-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMOS- JOHNSON",
        "first_name": "CASSANDRA",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2021-09-21",
        "certification_date": "2021-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "902422",
            "primary": true
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "MS",
            "license": "902422",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDRA",
            "last_name": "WALTERS",
            "middle_name": "SHARONETTE",
            "credential": "FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Allisa Alexander
• All at Home Personal Care and Respite Service
• Megan Allen
• Micah Beassie Allen, M.ED.,DT, CALT
• Amber Marie LLC
• Staci P Anding, PT
• Emily Diane Andrews-Wilkinson, NP
• Anne a. Henderson, Inc.
• Anointed Nephrology & HTN PLLC
• Madison Arant

• Family Nurse Practitioner in Brookhaven, MS
• Providers in Brookhaven, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.