Individual provider Active NPI

Cassidy Sea McGlothlen, NP

  • Nurse Practitioner
  • Hudson, WI
National Provider Identifier
1700262938
Registry record updated Jul 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
6551-33 Issued in WI
Practice address
2651 Hillcrest Dr
Hudson, WI 54016-4439
Phone
(715) 531-6800
Fax
(715) 531-6801
NPI assigned
Aug 11, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 6551-33 WI Primary

Addresses

Primary practice location

2651 Hillcrest Dr
Hudson, WI 54016-4439

Mailing address

2651 Hillcrest Dr
Suite 303
Hudson, WI 54016-4439
Phone (715) 531-6800

Other identifiers 1

IdentifierTypeStateIssuer
6551-33OtherWILICENSE

Other names 1

  • Cassidy Sea Phillips Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20150910001377 WI Practitioner - Nurse Practitioner 9638486517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hudson Physicians SCGroup PAC ID 2668607557, 62 clinicians

Practice addresses (Care Compare)

2651 Hillcrest Dr
Hudson, WI 54016-4439
Phone (715) 531-6800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
6551-33WIMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hudson Physicians, S.C. CurrentSince Oct 15, 2015 Accepting new patients
Hudson Physicians, S.C. CurrentSince Oct 15, 2015 Accepting new patients
Hudson Physicians, S.C. Past Accepting new patients

Locations

840 Spruce St
Baldwin, WI 54002
Phone (715) 235-4274

403 Stageline Rd
Hudson, WI 54016
Phone (715) 386-8880

2651 Hillcrest Dr
Hudson, WI 54016
Phone (630) 632-2648

2651 Hillcrest Dr
Ste 303
Hudson, WI 54016

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 and National Provider Directory roles.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1439251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690502400000",
    "number": "1700262938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DR",
            "address_2": "SUITE 303",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2651 HILLCREST DR",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164439",
            "telephone_number": "715-531-6800",
            "fax_number": "715-531-6801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLOTHLEN",
        "first_name": "CASSIDY",
        "middle_name": "SEA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-11",
        "last_updated": "2023-07-28",
        "certification_date": "2023-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "6551-33",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "6551-33",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "PHILLIPS",
            "middle_name": "SEA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Hudson, WI

Sources for this page

Verify at the official NPI Registry.