Individual provider Active NPI

Cassidi Rae Spurlock, PA

  • Physician Assistant
  • Lexington, KY
National Provider Identifier
1396591624
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA3581 Issued in KY
Practice address
1350 Bull Lea Rd
Lexington, KY 40511-1247
Phone
(859) 246-8000
Fax
(859) 246-8032
NPI assigned
Apr 26, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3581 KY
Surgical Physician Assistant 363AS0400X PA3581 KY
Physician Assistant 363A00000X PA3581 KY Primary

Addresses

Primary practice location

1350 Bull Lea Rd
Lexington, KY 40511-1247

Mailing address

6600 Flemingsburg Rd
Morehead, KY 40351-9144

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20241112001334 KY Practitioner - Physician Assistant 3678007721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of KentuckyGroup PAC ID 3072425289, 778 clinicians

Practice addresses (Care Compare)

101 Sanders-Brown BLDG
Lexington, KY 40536-0001
Phone (859) 257-1412

740 S Limestone
E214
Lexington, KY 40536-0001
Phone (859) 323-3368

770 Rose St
Mn328
Lexington, KY 40536-0001
Phone (859) 323-8873

800 Rose St
Lexington, KY 40536-0001
Phone (859) 257-8562

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA3581KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Kentucky CurrentSince Oct 14, 2024 Accepting new patients

Locations

1350 Bull Lea Rd
Lexington, KY 40511
Phone (859) 246-7363

800 Rose St
Lexington, KY 40536
Phone (859) 257-8562

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1396591624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6600 FLEMINGSBURG RD",
            "city": "MOREHEAD",
            "state": "KY",
            "postal_code": "403519144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 BULL LEA RD",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405111247",
            "telephone_number": "859-246-8000",
            "fax_number": "859-246-8032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPURLOCK",
        "first_name": "CASSIDI",
        "middle_name": "RAE",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-26",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "KY",
            "license": "PA3581",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA3581",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA3581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.