Active NPI
Cassandra Groth
- Clinical Psychologist
- Augusta, GA
National Provider Identifier
1912521394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY002466
- Practice address
- 3405 Mike Padgett Hwy
Augusta, GA 30906-3815 - Phone
- (706) 792-7141
- NPI assigned
- Jun 2, 2020
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY002466 | GA | Primary |
Addresses
Primary practice location
3405 Mike Padgett Hwy
Augusta, GA 30906-3815
Mailing address
1120 15TH St
Ste Bi1056
Augusta, GA 30912-0004
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY002466 | GA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591056000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592438400000",
"number": "1912521394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 15TH ST",
"address_2": "STE BI1056",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309120004"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3405 MIKE PADGETT HWY",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309063815",
"telephone_number": "706-792-7141"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROTH",
"first_name": "CASSANDRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-02",
"last_updated": "2020-06-18",
"certification_date": "2020-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "PSY002466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Augusta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.