Individual provider Active NPI

Glenn Sammons Cassell, PT, DPT

  • Physical Therapist
  • Warner Robins, GA
National Provider Identifier
1366814717
Registry record updated Oct 26, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012102 Issued in GA
Practice address
150 Osigian Blvd
Suite 300
Warner Robins, GA 31088-8968
Phone
(478) 333-3075
Fax
(478) 333-3484
NPI assigned
Oct 26, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012102 GA Primary

Addresses

Primary practice location

150 Osigian Blvd
Suite 300
Warner Robins, GA 31088-8968

Mailing address

150 Osigian Blvd
Suite 300
Warner Robins, GA 31088-8968
Phone (478) 333-3075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200404000047 CA Practitioner - Physical Therapist in Private Practice 3072815422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Western Physical Therapy IncGroup PAC ID 8022076348, 36 clinicians

Practice addresses (Care Compare)

37451 Main St
Suite Aandb
Burney, CA 96013-4372
Phone (530) 335-3206

Merit-based Incentive Payment System (MIPS)

Final score
76.21 of 100Reported as group
Quality
38.71
Promoting interoperability
100
Improvement activities
40
Cost
68.39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012102GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Feb 10, 2020 Accepting new patients
Western Physical Therapy, Inc. Physical Therapist CurrentSince Feb 10, 2020 Accepting new patients
R. Jason Kent Physical Therapy Physical Therapist PastSince Sep 20, 2015 Accepting new patients

Locations

37451 Main St
Ste Ab
Burney, CA 96013
Phone (530) 335-3206

844 Bridge St
Ste C
Colusa, CA 95932
Phone (530) 458-7770

1516 State Highway 99
Ste G
Gridley, CA 95948
Phone (530) 846-8018

1225 Eureka Way
#B
Redding, CA 96001
Phone (530) 247-1280

Organizations & group practices 3

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": "1445817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445817600000",
    "number": "1366814717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 OSIGIAN BLVD",
            "address_2": "SUITE 300",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888968",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 OSIGIAN BLVD",
            "address_2": "SUITE 300",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888968",
            "telephone_number": "478-333-3075",
            "fax_number": "478-333-3484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSELL",
        "first_name": "GLENN",
        "middle_name": "SAMMONS",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-26",
        "last_updated": "2015-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2015; 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.