Cassandra Lee Coghlan, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

006463 Issued in GA

Practice address

960 Johnson Ferry Rd
Ste 940
Atlanta, GA 30342-1631

Phone

(404) 851-6000

Fax

(404) 252-2736

NPI assigned

Jun 20, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Ms. Lee Coghlan Other name

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Emory University School of Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Hospital, Atlanta, GA, CCN 110161
• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485907200000",
    "number": "1649533035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "STE 940",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-851-6000",
            "fax_number": "404-252-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 JOHNSON FERRY RD",
            "address_2": "STE 940",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421631",
            "telephone_number": "404-851-6000",
            "fax_number": "404-252-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COGHLAN",
        "first_name": "CASSANDRA",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2017-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "006463",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "006463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1649533035",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003125044B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEE",
            "last_name": "COGHLAN",
            "prefix": "MS.",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sarah Marie Cofelice, M.A., BCBA
• Sarah Katie Dupree Coffee, PHARM.D.
• Mary Virginia Coffman, MS, CNS, LDN, LN
• Cantrella V Cofield, LMT
• Cherry Celeste Coggin, D.M.D.
• Cognisance Corp (Ellie Mental Health Atlanta)
• Cognitive Counseling Consultants of Georgia
• Cognitive Rehabilitation of Georgia, PC
• Jodie D Cohan, PHARM.D.
• Cohen Chiropractic Centre

• Medical Physician Assistant in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.