Cassandra L Wilson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

62301 Issued in GA

Practice address

80 Cinema Dr
Ellijay, GA 30540-2592

Phone

(706) 635-6898

Fax

(706) 635-6885

NPI assigned

Jan 25, 2008

Last updated

Feb 9, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cassandra.wilson.1@20104.direct.athenahealth.com
• Direct secure messaging: cassandra.wilson@bacon.gadirect.net

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.

• Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Blue Ridge, GA
  • NPI 1538123666
  Medicare reassignment NPD
• Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dahlonega, GA
  • NPI 1285057281
  NPD
• Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • La Fayette, GA
  • NPI 1932991791
  NPD
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Chatsworth, GA
  • NPI 1144419813
  NPD (past)
• Georgia Mountains Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Dahlonega, GA
  • NPI 1962189449
  NPD (past)
• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1487831020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 BLUE RIDGE OVERLOOK",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134431",
            "telephone_number": "706-946-5607",
            "fax_number": "706-374-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 CINEMA DR",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305402592",
            "telephone_number": "706-635-6898",
            "fax_number": "706-635-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CASSANDRA",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-25",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "62301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James William White Jr., CRNA
• Jo A White
• Carley Whitlow
• Willow Creek Adolescent Substance Abuse Program
• Willow Creek Substance Abuse Program
• Judy Carol Wright
• Xyz Medical
• Grayson York
• Suzanne Young, APRN, WHNP-BC
• Erica Allyne Zippel, DPT

• Pediatrics Physician in Ellijay, GA
• Providers in Ellijay, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.