Individual provider Active NPI

Cassandra Ann Harrison, FNP-BC

  • General Practice Physician
  • Gulf Breeze, FL
National Provider Identifier
1932804176
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
11025519 Issued in FL
Practice address
1533 Oakhill Rd
Gulf Breeze, FL 32563-2800
Phone
(850) 292-7962
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 11025519 FL Primary

Addresses

Primary practice location

1533 Oakhill Rd
Gulf Breeze, FL 32563-2800

Mailing address

1533 Oakhill Rd
Gulf Breeze, FL 32563-2800
Phone (850) 292-7962

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230628000661 FL Practitioner - Nurse Practitioner 5496113144 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11025519FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physician Services Group of Florida, LLC CurrentSince May 1, 2023 Accepting new patients
Psgfl MSSP, LLC CurrentSince Jul 24, 2025 Accepting new patients

Locations

8325 University Pkwy
Ste A
Pensacola, FL 32514
Phone (850) 324-9633

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680566400000",
    "number": "1932804176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1533 OAKHILL RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632800",
            "telephone_number": "850-292-7962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1533 OAKHILL RD",
            "city": "GULF BREEZE",
            "state": "FL",
            "postal_code": "325632800",
            "telephone_number": "850-292-7962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRISON",
        "first_name": "CASSANDRA",
        "middle_name": "ANN",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "11025519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulf Breeze, FL

Sources for this page

Verify at the official NPI Registry.