Individual provider Active NPI

Cassandra Lashea Doss, MSN, FNP-BC

  • Family Nurse Practitioner
  • Jackson, MO
National Provider Identifier
1649747403
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
2018039453 Issued in MO
Practice address
3130 E Jackson Blvd
Jackson, MO 63755-2957
Phone
(573) 243-5095
NPI assigned
Oct 30, 2018
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 2018039453 MO Primary

Addresses

Primary practice location

3130 E Jackson Blvd
Jackson, MO 63755-2957

Mailing address

922 Gerald St
Jackson, MO 63755-2656
Phone (573) 225-2845

Other names 1

  • Casey Lashea Kern Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20181129002561 MO Practitioner - Nurse Practitioner 6103160270 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pappas Chiropractic Health Center PCGroup PAC ID 5294760484, 4 clinicians

Practice addresses (Care Compare)

3130 E Jackson Blvd
Jackson, MO 63755-2957
Phone (573) 243-5095

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
2018039453MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Practice, PC Current Accepting new patients
Riverside Family Medicine PC CurrentSince Nov 1, 2018 Accepting new patients
Pappas Chiropractic Health Center, P.C. Family CurrentSince Jan 5, 2022 Accepting new patients

Locations

3129 Blattner Dr
Cpe Girardeau, MO 63703
Phone (573) 335-0166

3130 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-5095

702 Highway 34 W
Marble Hill, MO 63764
Phone (573) 238-2614

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1649747403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 GERALD ST",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552656",
            "telephone_number": "573-225-2845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3130 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637552957",
            "telephone_number": "573-243-5095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOSS",
        "first_name": "CASSANDRA",
        "middle_name": "LASHEA",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2018039453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASEY",
            "last_name": "KERN",
            "middle_name": "LASHEA",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Jackson, MO

Sources for this page

Verify at the official NPI Registry.