Active NPI
Cassandra Ann Andella
- Nurse Practitioner
- Jacksonville, FL
National Provider Identifier
1851072755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN9416192
- Practice address
- 13057 Viburnum Dr N
Jacksonville, FL 32246-1145 - Phone
- (978) 502-3786
- NPI assigned
- Jul 25, 2023
- Last updated
- Jul 25, 2023
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN9416192 | FL | Primary |
Addresses
Primary practice location
13057 Viburnum Dr N
Jacksonville, FL 32246-1145
Mailing address
13057 Viburnum Dr N
Jacksonville, FL 32246-1145
Phone (978) 502-3786
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
| License | State | Type | Specialty |
|---|---|---|---|
| RN9416192 | FL | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1690243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690243200000",
"number": "1851072755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13057 VIBURNUM DR N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322461145",
"telephone_number": "978-502-3786"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13057 VIBURNUM DR N",
"city": "JACKSONVILLE",
"state": "FL",
"postal_code": "322461145",
"telephone_number": "978-502-3786"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDELLA",
"first_name": "CASSANDRA",
"middle_name": "ANN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-07-25",
"last_updated": "2023-07-25",
"certification_date": "2023-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "FL",
"license": "RN9416192",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.