Cassandra L. Kellams

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

71016302A Issued in IN

Practice address

203 W 1St St
Bloomington, IN 47403-2504

Phone

(812) 668-1946

Fax

(812) 287-8438

NPI assigned

Aug 8, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cleanslate Medical Group of Indiana LLCGroup PAC ID 4880963909, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Cleanslate Medical Group of Indiana LLC

  • Addiction Medicine (Internal Medicine) Physician
  • Alexandria, IN
  • NPI 1023464294
  Medicare reassignment Care Compare group NPD
• Provider Partners Care Management LP

  • Nurse Practitioner
  • Columbia, MD
  • NPI 1013348028

  IN

  Medicare reassignment NPD
• Cleanslate Medical Group of Pennsylvania LLC

  • Multi-Specialty Clinic/Center
  • Wilkes Barre, PA
  • NPI 1184177263
  NPD (past)

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758672000000",
    "number": "1972334282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10782 W OLD VINCENNES RD",
            "city": "WEST BADEN SPRINGS",
            "state": "IN",
            "postal_code": "474699669",
            "telephone_number": "812-508-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 W 1ST ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032504",
            "telephone_number": "812-668-1946",
            "fax_number": "812-287-8438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10782 W Old Vincennes Rd",
            "address_purpose": "LOCATION",
            "city": "West Baden Springs",
            "state": "IN",
            "postal_code": "474699669",
            "country_code": "US",
            "telephone_number": "812-508-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLAMS",
        "first_name": "CASSANDRA",
        "middle_name": "L.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-08",
        "last_updated": "2025-09-24",
        "certification_date": "2025-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71016302A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailee Rochelle Keen, ATC
• Audrey Keepes, RBT
• Elizabeth Keith, RBT
• Jennifer Keith, PA
• Rebecca Anne Keith, M.D.
• Jennifer Kellams
• Amy J Keller, PTA
• Matthew Keller, OD
• Olivia Keller
• Walt Keller, HSPP

• Family Nurse Practitioner in Bloomington, IN
• Providers in Bloomington, IN by specialty
• Family Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.