Individual provider Active NPI

Kasandra Kay Wilmore, CCRN

  • Registered Nurse
  • Cookeville, TN
National Provider Identifier
1740131432
Registry record updated Feb 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
269330 Issued in TN
Practice address
1 Medical Blvd
Cookeville, TN 38505-0001
Phone
(931) 783-5032
NPI assigned
Feb 7, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 7, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163W00000X 269330 TN Primary

Addresses

Primary practice location

1 Medical Blvd
Cookeville, TN 38505-0001

Mailing address

108 Standing Rock Rd
Deer Lodge, TN 37726-3818
Phone (931) 704-1607

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
269330TNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1770422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770422400000",
    "number": "1740131432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 STANDING ROCK RD",
            "city": "DEER LODGE",
            "state": "TN",
            "postal_code": "377263818",
            "telephone_number": "931-704-1607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL BLVD",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385050001",
            "telephone_number": "931-783-5032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMORE",
        "first_name": "KASANDRA",
        "middle_name": "KAY",
        "credential": "CCRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-07",
        "last_updated": "2026-02-07",
        "certification_date": "2026-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "269330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cookeville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2026; 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.