Individual provider Active NPI

Casey Elizabeth Herdson, PA-C

  • Surgical Physician Assistant
  • Hillsborough, NC
National Provider Identifier
1922255215
Registry record updated Sep 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-05944 Issued in NC
Practice address
460 Waterstone Dr
Hillsborough, NC 27278-9078
Phone
(984) 974-0085
NPI assigned
Aug 19, 2008
Last updated
Sep 4, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X 0010-05944 NC Primary

Addresses

Primary practice location

460 Waterstone Dr
Hillsborough, NC 27278-9078

Mailing address

460 Waterstone Dr
Hillsborough, NC 27278-9078
Phone (984) 974-0085

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210726001238 MD Practitioner - Physician Assistant 1557439783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Agnes Healthcare IncGroup PAC ID 9830092733, 265 clinicians

Practice addresses (Care Compare)

900 Caton Ave
Baltimore, MD 21229-5201
Phone (667) 234-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Agnes Healthcare Inc CurrentSince Aug 6, 2025 Accepting new patients
St Agnes Healthcare Inc CurrentSince Aug 6, 2025 Accepting new patients

Locations

900 S Caton Ave
Baltimore, MD 21229
Phone (410) 368-3120

Organizations & group practices 2

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441324800000",
    "number": "1922255215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 WATERSTONE DR",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272789078",
            "telephone_number": "984-974-0085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 WATERSTONE DR",
            "city": "HILLSBOROUGH",
            "state": "NC",
            "postal_code": "272789078",
            "telephone_number": "984-974-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERDSON",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-19",
        "last_updated": "2015-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-05944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hillsborough, NC

Sources for this page

Verify at the official NPI Registry.