Kacey Lynn Glasscock, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

921 Lakeview Blvd
New Braunfus, TX 78130

Phone

(830) 620-7744

Fax

(830) 625-0353

NPI assigned

Jan 15, 2013

Last updated

Mar 11, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kacey Lynn Flanagan Former name

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• CC Healthcare Systems, LLC

  dba New Braunfels Rural Health Clinic

  • General Practice Physician
  • New Braunfels, TX
  • NPI 1881922102
  Medicare reassignment

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

{
    "created_epoch": "1358208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457654400000",
    "number": "1669719365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "921 LAKEVIEW BLVD",
            "city": "NEW BRAUNFUS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "830-620-7744",
            "fax_number": "830-625-0353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 LAKEVIEW BLVD",
            "city": "NEW BRAUNFUS",
            "state": "TX",
            "postal_code": "78130",
            "telephone_number": "830-620-7744",
            "fax_number": "830-625-0353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLASSCOCK",
        "first_name": "KACEY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-15",
        "last_updated": "2016-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KACEY",
            "last_name": "FLANAGAN",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.