Individual provider Active NPI

Cassandra A Gladkowski, FNP

  • Family Nurse Practitioner
  • Murfreesboro, TN
National Provider Identifier
1396168019
Registry record updated Aug 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
18299 Issued in TN
Practice address
1020 N Highland Ave
Murfreesboro, TN 37130-2494
Phone
(615) 396-6620
Fax
(615) 396-6625
NPI assigned
Jan 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 180907 TN
Family Nurse Practitioner 363LF0000X 18299 TN Primary

Addresses

Primary practice location

1020 N Highland Ave
Murfreesboro, TN 37130-2494

Mailing address

501 Great Circle Rd
Ste. 200
Nashville, TN 37228-1317
Phone (615) 222-7685

Other identifiers 1

IdentifierTypeStateIssuer
Q011185MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150605000879 TN Practitioner - Family Practice 3577884311 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Mar 29, 2015 Accepting new patients

Locations

1020 N Highland Ave
Murfreesboro, TN 37130
Phone (615) 396-6620

501 Great Circle Rd
Ste 200
Nashville, TN 37228
Phone (615) 396-4694

300 20th Ave N
Fl 9
Nashville, TN 37203

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": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471478400000",
    "number": "1396168019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 GREAT CIRCLE RD",
            "address_2": "STE. 200",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372281317",
            "telephone_number": "615-222-7685",
            "fax_number": "615-222-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 N HIGHLAND AVE",
            "city": "MURFREESBORO",
            "state": "TN",
            "postal_code": "371302494",
            "telephone_number": "615-396-6620",
            "fax_number": "615-396-6625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLADKOWSKI",
        "first_name": "CASSANDRA",
        "middle_name": "A",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2016-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "180907",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "18299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q011185",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murfreesboro, TN

Sources for this page

Verify at the official NPI Registry.