Active NPI
Cassie Ann Wellock, PA-C
- Physician Assistant
- Reno, NV
National Provider Identifier
1720327869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA1396
- Practice address
- 1065 S Virginia St
Reno, NV 89502-2417 - Phone
- (775) 364-3350
- Fax
- (775) 218-5636
- NPI assigned
- Feb 9, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA1396 | NV | Primary |
Addresses
Primary practice location
1065 S Virginia St
Reno, NV 89502-2417
Mailing address
1065 S Virginia St
Reno, NV 89502-2417
Phone (775) 364-3350
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 12788722 | Other | NV | CAQH ID # |
| PA1396 | Other | NV | PAC LIC # |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1360368000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1743552000000",
"number": "1720327869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1065 S VIRGINIA ST",
"city": "RENO",
"state": "NV",
"postal_code": "895022417",
"telephone_number": "775-364-3350",
"fax_number": "775-218-5636"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1065 S VIRGINIA ST",
"city": "RENO",
"state": "NV",
"postal_code": "895022417",
"telephone_number": "775-364-3350",
"fax_number": "775-218-5636"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WELLOCK",
"first_name": "CASSIE",
"middle_name": "ANN",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-02-09",
"last_updated": "2025-04-02",
"certification_date": "2025-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "NV",
"license": "PA1396",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH ID #",
"identifier": "12788722",
"state": "NV"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PAC LIC #",
"identifier": "PA1396",
"state": "NV"
}
],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.