Kassandra Williams, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

2022039976 Issued in MO

Practice address

10012 Kennerly Rd Ste 300
Saint Louis, MO 63128-2197

Phone

(314) 692-2807

Fax

(314) 991-0727

NPI assigned

Aug 30, 2022

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

• Kassandra Heren Former name

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

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Clinic Heart and Vascular LLCGroup PAC ID 8820016207, 112 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital South Hospital, Saint Louis, MO, CCN 260077
• Red Bud Regional Hospital Hospital, Red Bud, IL, CCN 141348
• Mercy Hospital St Louis Hospital, Saint Louis, MO, CCN 260020

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.

• Mercy Clinic Heart and Vascular, LLC

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1932176401
  Medicare reassignment Care Compare group

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

• Mercy Hospital South

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1568481984
  Care Compare affiliation
• Mercy Hospitals East Communities

  • General Acute Care Hospital
  • Saint Louis, MO
  • NPI 1427098169
  Care Compare affiliation
• Mercy Hospitals East Communities

  • Land Ambulance
  • Saint Louis, MO
  • NPI 1881329902

  Hospital

  Care Compare affiliation
• Deaconess Illinois Red Bud Regional Hospital Inc

  • Critical Access Hospital
  • Red Bud, IL
  • NPI 1407573132
  Care Compare affiliation

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

{
    "created_epoch": "1661817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781827200000",
    "number": "1699495770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-692-2807",
            "fax_number": "314-991-0727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 KENNERLY RD STE 300",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282197",
            "telephone_number": "314-692-2807",
            "fax_number": "314-991-0727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KASSANDRA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-30",
        "last_updated": "2026-06-19",
        "certification_date": "2026-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2022039976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KASSANDRA",
            "last_name": "HEREN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Joelle Williams, LCSW
• Johnisha Williams
• Joseph John Williams, MD
• Julia Molloy Williams
• Jymira Lee Williams, CNA
• Katema Nicole Williams
• Katherine Ann Williams, BC-HIS
• Katherine Annette Williams, LCSW
• Katherine Nicole Williams, MD
• Kathleen Anne Williams, M.S.W.

• Physician Assistant in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2026; 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.