Individual provider Active NPI

Cassie Speck

  • Women's Health Nurse Practitioner
  • Skokie, IL
National Provider Identifier
1578968244
Registry record updated Feb 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
209.026217 Issued in IL
Practice address
4711 Golf Rd Ste 920
Skokie, IL 60076-1247
Phone
(855) 729-2272
Fax
(224) 330-1064
NPI assigned
Oct 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 19304 TN
Women's Health Nurse Practitioner 363LW0102X 209.026217 IL Primary

Addresses

Primary practice location

4711 Golf Rd Ste 920
Skokie, IL 60076-1247

Mailing address

5002 Crossing Circle
Suite 260
Mt Juliet, TN 37122-8590
Phone (855) 729-2272

Other practice location 1

5002 Crossing Circle
Suite 260
Mt Juliet, TN 37122-8590
Phone (855) 729-2272

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230216002377 IL Practitioner - Nurse Practitioner 2860876315 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
19304TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood Greater Memphis Region Past Accepting new patients
Femhealth USA, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: cassie.speck.1@10306.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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676246400000",
    "number": "1578968244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5002 CROSSING CIRCLE",
            "address_2": "SUITE 260",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371228590",
            "telephone_number": "855-729-2272",
            "fax_number": "615-250-6296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4711 GOLF RD STE 920",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761247",
            "telephone_number": "855-729-2272",
            "fax_number": "224-330-1064"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5002 Crossing Circle",
            "address_2": "Suite 260",
            "address_purpose": "LOCATION",
            "city": "Mt Juliet",
            "state": "TN",
            "postal_code": "371228590",
            "country_code": "US",
            "telephone_number": "855-729-2272",
            "fax_number": "615-250-6296",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPECK",
        "first_name": "CASSIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2023-02-13",
        "certification_date": "2023-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "19304",
            "primary": false
        },
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "IL",
            "license": "209.026217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.