Kasey A Statum, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

ME114685 Issued in FL

Practice address

1500 Lakeland Hills Blvd Ste 1
Lakeland, FL 33805-3257

Phone

(832) 242-4735

Fax

(239) 302-1344

NPI assigned

Jun 1, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Winchester, VA
  • NPI 1023217452
  NPD (past)
• Shenandoah Valley Medical System, Inc.

  • Federally Qualified Health Center (FQHC)
  • Berkeley Springs, WV
  • NPI 1568186153
  NPD (past)

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1720082076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4437 N CANDLEWOOD DR",
            "city": "BEVERLY HILLS",
            "state": "FL",
            "postal_code": "344658907",
            "telephone_number": "301-254-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 LAKELAND HILLS BLVD STE 1",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338053257",
            "telephone_number": "832-242-4735",
            "fax_number": "239-302-1344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STATUM",
        "first_name": "KASEY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-01",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WV",
            "license": "21877",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101246540",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "227551",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME114685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810003695",
            "state": "WV"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "K.Statum@inspiremedical.com",
            "affiliation": "Y",
            "affiliationName": "INSPIRE MEDICAL GROUP INC",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "I dont know",
            "address_1": "1500 Lakeland Hills Blvd Ste 1",
            "city": "Lakeland",
            "state": "FL",
            "country_code": "US",
            "postal_code": "338053257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Sue Ann Stanley-Green, ATC
• Nigel Stanley, RN
• Star Psychology, LLC
• Star Psychology, LLC
• Doran Robert Stark, MD
• Judy D Stavely, CST
• Katherine Steadman, LMHC
• Tara Lynn Steakin, PHARMD
• Jennifer O. Steed, AU.D.
• Macey Faith Steedley

• Pediatrics Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Pediatrics Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.