Cassondra Davis

Primary specialty

Social WorkerTaxonomy code 104100000X

License

101097 Issued in NY

Practice address

1001 West St
Carthage, NY 13619-9703

Phone

(315) 519-5828

NPI assigned

Aug 4, 2016

Sex

Female

Sole proprietor

No

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.

• Children'S Home of Jefferson County

  • Community/Behavioral Health Agency
  • Watertown, NY
  • NPI 1538455696
  NPD (past)
• Children'S Home of Jefferson County

  • Case Management Agency
  • Watertown, NY
  • NPI 1770625527
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

• Cassondra San Miguel Former name

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 25, 2021.

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1609320993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199703",
            "telephone_number": "315-519-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 WEST ST",
            "city": "CARTHAGE",
            "state": "NY",
            "postal_code": "136199703",
            "telephone_number": "315-519-5828"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "167 Polk St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Watertown",
            "state": "NY",
            "postal_code": "136012097",
            "country_code": "US",
            "telephone_number": "315-782-7445",
            "fax_number": "315-779-1184",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CASSONDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "101097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSONDRA",
            "last_name": "SAN MIGUEL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Julie Ann Crabb, RN
• Kathleen A Craig, LPN
• Jerome F Cuyler, M.D.
• Gaston F Dacosta, MD
• Abbey Jane Darling, PA-C
• Debra J Williams Podiatrist PC
• Debra J Williams Podiatrist PC
• Danielle Defeo, OT
• Karen Deir, RN
• Leo Andrei Delacruz

• All providers in Carthage, NY
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.