Casady Blauw Gaines, MD

Key facts

NPI

1730103599

Entity type

Individual (NPI type 1)

Primary specialty

Pediatrics Physician 208000000X

License

ME80631 (FL)

Practice address

223 N Main St
Williston, FL 32696-2136

Phone

(352) 529-0477

Fax

(352) 529-0406

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: casadygaines@willistonpeds.directglo.com

Specialties & licenses

Addresses

Other identifiers

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 9, 2011.

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315526400000",
    "number": "1730103599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962136",
            "telephone_number": "352-529-0477",
            "fax_number": "352-529-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 N MAIN ST",
            "city": "WILLISTON",
            "state": "FL",
            "postal_code": "326962136",
            "telephone_number": "352-529-0477",
            "fax_number": "352-529-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAINES",
        "first_name": "CASADY",
        "middle_name": "BLAUW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2011-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "ME80631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "275068600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sumayya Ghalaini
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• Good Samaritan Retirement Home
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All providers in Williston, FL · Pediatrics Physician in Florida