Active NPI
Cassandra L Jeandell
- Physician Assistant
- Bradenton, FL
National Provider Identifier
1982252870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9112685
- Practice address
- 2020 59TH St W
Bradenton, FL 34209-4604 - Phone
- (706) 863-9595
- Fax
- (706) 868-8375
- NPI assigned
- Sep 3, 2019
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA9112685 | FL | Primary |
Addresses
Primary practice location
2020 59TH St W
Bradenton, FL 34209-4604
Mailing address
PO Box 3725
Augusta, GA 30914-3725
Phone (706) 863-9595
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9112685 | FL | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1567468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1616025600000",
"number": "1982252870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 3725",
"city": "AUGUSTA",
"state": "GA",
"postal_code": "309143725",
"telephone_number": "706-863-9595",
"fax_number": "706-868-8375"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2020 59TH ST W",
"city": "BRADENTON",
"state": "FL",
"postal_code": "342094604",
"telephone_number": "706-863-9595",
"fax_number": "706-868-8375"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEANDELL",
"first_name": "CASSANDRA",
"middle_name": "L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-03",
"last_updated": "2021-03-18",
"certification_date": "2021-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "FL",
"license": "PA9112685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bradenton, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.