Cassidy Elaine Gonzalez

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

124608261206 Issued in UT

Practice address

116 N 700 E
Provo, UT 84606-3321

Phone

(435) 770-2898

NPI assigned

Aug 6, 2021

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 names 1

• Cassidy Elaine Craig Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Valley Obstetrics and Gynecology, P.C.

  • Clinical Medical Laboratory
  • Provo, UT
  • NPI 1346718764
  NPD (past)
• Valley Obstetrics and Gynecology, P.C.

  • Reproductive Endocrinology Physician
  • Provo, UT
  • NPI 1770050221
  NPD (past)
• Valley Obstetrics and Gynecology, PC

  • Obstetrics & Gynecology Physician
  • St George, UT
  • NPI 1568478170
  NPD (past)

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

{
    "created_epoch": "1628208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1689348229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063321",
            "telephone_number": "435-770-2898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 N 700 E",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846063321",
            "telephone_number": "435-770-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALEZ",
        "first_name": "CASSIDY",
        "middle_name": "ELAINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-06",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "124608261206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "CRAIG",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Christian Gomez, DC
• Kelly Allan Gomez, DPM
• Robert Gomm, EDS
• Giovani Gongora
• Brett Esteban Gonzalez, CSW
• Dereck Hugh Gonzalez, CSW
• Eunice Gonzalez
• Lindsay Gonzalez, LCSW
• Lindsay Jan Gonzalez, M.S. CCC-SLP
• Nicole Elizabeth Gonzalez

• All providers in Provo, UT
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.