Individual provider Active NPI

Casandra Sue Gammage, NP

  • Primary Care Nurse Practitioner
  • Midland, GA
National Provider Identifier
1861961534
Registry record updated Nov 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN202261 Issued in GA
Practice address
71 Boxwood LN
Midland, GA 31820-4599
Phone
(706) 221-6005
NPI assigned
Nov 24, 2018
Last updated
Nov 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN202261 GA Primary

Addresses

Primary practice location

71 Boxwood LN
Midland, GA 31820-4599

Mailing address

71 Boxwood LN
Midland, GA 31820-4599
Phone (706) 221-6005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, GA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190403001281 AL Practitioner - Nurse Practitioner 1052652914 Reassigns benefits to 2 organizations
I20210830002402 GA Practitioner - Nurse Practitioner 1052652914 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgencare, LLCGroup PAC ID 7113250325, 18 clinicians
Peachtree Immediate Care FP, LLCGroup PAC ID 3274559323, 328 clinicians

Practice addresses (Care Compare)

153 S College St
Hamilton, GA 31811-5306
Phone (706) 801-0251

2000 Samglenn Dr
Suite 200
Auburn, AL 36830-6549
Phone (334) 752-7022

2169 W Point Rd
Suite 300
Lagrange, GA 30240-4037
Phone (706) 668-5140

2606 Manchester Expy
Columbus, GA 31904-5207
Phone (706) 989-5903

3543 US Hwy 431 N
Suite D
Phenix City, AL 36867
Phone (334) 214-1080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN202261GAMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Rural Urgent Care LLC CurrentSince Jan 22, 2019 Accepting new patients
Rural Urgent Care LLC CurrentSince Jan 22, 2019 Accepting new patients

Locations

1500 1st Ave N
Unit 3
Birmingham, AL 35203
Phone (205) 545-5088

1925 W Main St
#120
Centre, AL 35960
Phone (256) 677-4552

1026 S Eufaula Ave
Eufaula, AL 36027
Phone (334) 687-5775

3306 20th Ave
Valley, AL 36854
Phone (205) 545-5090

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1543017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543017600000",
    "number": "1861961534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BOXWOOD LN",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318204599",
            "telephone_number": "706-221-6005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 BOXWOOD LN",
            "city": "MIDLAND",
            "state": "GA",
            "postal_code": "318204599",
            "telephone_number": "706-221-6005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMAGE",
        "first_name": "CASANDRA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-24",
        "last_updated": "2018-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "GA",
            "license": "RN202261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, GA

Sources for this page

Verify at the official NPI Registry.