Kennedy Marie Cassidy, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11014372 Issued in FL

Practice address

1016 Kelly Creek Cir
Oviedo, FL 32765-5702

Phone

(407) 761-5561

NPI assigned

Aug 27, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Kennedy Marie Krakar Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1630022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630022400000",
    "number": "1629745534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 KELLY CREEK CIR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655702",
            "telephone_number": "407-761-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 KELLY CREEK CIR",
            "city": "OVIEDO",
            "state": "FL",
            "postal_code": "327655702",
            "telephone_number": "407-761-5561"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1340 Tuskawilla Rd Ste 113",
            "address_purpose": "LOCATION",
            "city": "Winter Springs",
            "state": "FL",
            "postal_code": "327085030",
            "country_code": "US",
            "telephone_number": "407-331-4777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CASSIDY",
        "first_name": "KENNEDY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-27",
        "last_updated": "2021-08-27",
        "certification_date": "2021-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11014372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KENNEDY",
            "last_name": "KRAKAR",
            "middle_name": "MARIE",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexis K Carr, COTA/L
• Christina Carraha, MA
• Victoria Shea Carrasco, M.A., CF-SLP
• Gabriel Carrasquillo
• Lyret Carrasquillo
• Alexandria Castillo
• Cat Assessments, LLC
• Catherine a. Hunt Inc.
• Catherine a. Hunt Incorporated
• Catherine F. Dunlap, LCSW, LLC.

• Family Nurse Practitioner in Oviedo, FL
• Providers in Oviedo, FL by specialty
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.