Individual provider Active NPI

Cassandra Marie Ladd-Bashford, P.T.

  • Specialist
  • Watertown, NY
National Provider Identifier
1619201795
Registry record updated Sep 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
031876 Issued in NY
Practice address
19472 US RT 11
Watertown, NY 13601
Phone
(315) 782-6126
Fax
(315) 782-3816
NPI assigned
Sep 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 031876 NY Primary

Addresses

Primary practice location

19472 US RT 11
Watertown, NY 13601

Mailing address

19472 US RT 11
Watertown, NY 13601
Phone (315) 782-6126

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091118000621 NY Practitioner - Physical Therapist in Private Practice 9931247558 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
031876NYMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Cani PT OT SLP & Psychology PLLC Specialist CurrentSince Sep 23, 2009 Accepting new patients

Locations

216 County Route 64
Mexico, NY 13114
Phone (315) 963-0864

19472 US Route 11
Watertown, NY 13601
Phone (315) 782-6126

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.

NPI Registry JSON

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1619201795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19472 US RT 11",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-782-6126",
            "fax_number": "315-782-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19472 US RT 11",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "13601",
            "telephone_number": "315-782-6126",
            "fax_number": "315-782-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LADD-BASHFORD",
        "first_name": "CASSANDRA",
        "middle_name": "MARIE",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "031876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.