Individual provider Active NPI

Casey Arnold

  • Emergency Medicine Physician
  • Tallahassee, FL
National Provider Identifier
1932563145
Registry record updated May 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
135552 Issued in FL
Practice address
2626 Capital Medical Blvd
Tallahassee, FL 32308-4402
Phone
(321) 505-6620
NPI assigned
Apr 13, 2016
Last updated
May 1, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Emergency Medicine Physician 207P00000X 135552 FL Primary

Addresses

Primary practice location

2626 Capital Medical Blvd
Tallahassee, FL 32308-4402

Mailing address

2808 Harper PL
Tampa, FL 33614-4331
Phone (321) 505-6620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190618003205 FL Practitioner - Emergency Medicine 2961736376 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
135552FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Oliver Emergency Group, LLC Emergency Medicine CurrentSince Jun 21, 2022 Accepting new patients
Lake Oliver Emergency Group, LLC Emergency Medicine CurrentSince Jun 21, 2022 Accepting new patients

Locations

23186 Blue Star Hwy
Quincy, FL 32351
Phone (850) 875-5977

2626 Capital Medical Blvd
Tallahassee, FL 32308
Phone (850) 325-5000

Organizations & group practices 3

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": "1460505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556668800000",
    "number": "1932563145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2808 HARPER PL",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336144331",
            "telephone_number": "321-505-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 CAPITAL MEDICAL BLVD",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323084402",
            "telephone_number": "321-505-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "CASEY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-13",
        "last_updated": "2019-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "135552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tallahassee, FL

Sources for this page

Verify at the official NPI Registry.