Individual provider Active NPI

Heather M Cassidy, M.D.

  • Internal Medicine Physician
  • Fort Carson, CO
National Provider Identifier
1497983654
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0057007 Issued in CO
Practice address
1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone
(719) 525-7000
NPI assigned
Jun 26, 2009
Last updated
Feb 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD13927 RI
Internal Medicine Physician 207R00000X DR.0057007 CO Primary

Addresses

Primary practice location

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604

Mailing address

1650 Cochrane Cir Unit Meddac
Fort Carson, CO 80913-4604
Phone (719) 526-7000

Other identifiers 1

IdentifierTypeStateIssuer
65375033MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20150702000477 UT Practitioner - Internal Medicine 6002059219 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
DR.0057007COMDInternal Medicine Physician
MD13927RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Aug 1, 2015 Accepting new patients

Locations

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: heather.cassidy.1@17631.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1497983654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-526-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 COCHRANE CIR UNIT MEDDAC",
            "city": "FORT CARSON",
            "state": "CO",
            "postal_code": "809134604",
            "telephone_number": "719-525-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "HEATHER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-26",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD13927",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0057007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "65375033",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Carson, CO

Sources for this page

Verify at the official NPI Registry.