Individual provider Active NPI

Cassandra Ann Davis, DPT

  • Physical Therapist
  • Big Rapids, MI
National Provider Identifier
1811534589
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1268 Perry Ave
Big Rapids, MI 49307-2115
Phone
(231) 796-4419
NPI assigned
Dec 2, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Physical Therapist 225100000X Primary

Addresses

Primary practice location

1268 Perry Ave
Big Rapids, MI 49307-2115

Mailing address

1268 Perry Ave
Big Rapids, MI 49307-2115
Phone (231) 796-4419

Other practice location 1

11125 Birwood Dr
Stanwood, MI 49346-9773
Phone (231) 629-9528

Other names 1

  • Cassanda Ann Cole Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240916001380 MI Practitioner - Physical Therapist in Private Practice 6103367339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1268 Perry Ave
Big Rapids, MI 49307-2115
Phone (231) 796-4419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Evergreen Physical Therapy Limited Partnership Physical Therapist Current Accepting new patients
Evergreen Physical Therapy Limited Partnership Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Evergreen Physical Therapy Limited Partnership Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Evergreen Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients

Locations

1268 Perry Ave
Big Rapids, MI 49307
Phone (231) 796-4419

107 Schoolcrest Ave
Clare, MI 48617
Phone (989) 386-9170

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1575244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1811534589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 PERRY AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072115",
            "telephone_number": "231-796-4419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 PERRY AVE",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072115",
            "telephone_number": "231-796-4419"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11125 Birwood Dr",
            "address_purpose": "LOCATION",
            "city": "Stanwood",
            "state": "MI",
            "postal_code": "493469773",
            "country_code": "US",
            "telephone_number": "231-629-9528",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "CASSANDRA",
        "middle_name": "ANN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-02",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSANDA",
            "last_name": "COLE",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Big Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.