Individual provider Active NPI

Cassandra Renee Ford

  • Transportation Broker
  • Chattanooga, TN
National Provider Identifier
1982253977
Registry record updated Sep 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation BrokerTaxonomy code 347E00000X
License
065191300 Issued in TN
Practice address
2712 Benton Ave
Chattanooga, TN 37406-3620
Phone
(423) 876-5309
Fax
(423) 485-6601
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Broker 347E00000X 065191300 TN Primary

Addresses

Primary practice location

2712 Benton Ave
Chattanooga, TN 37406-3620

Mailing address

2712 Benton Ave
Chattanooga, TN 37406-3620
Phone (423) 876-5309

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
065191300TNMDTransportation Broker

NPI Registry JSON

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

{
    "created_epoch": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568160000000",
    "number": "1982253977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 BENTON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374063620",
            "telephone_number": "423-876-5309",
            "fax_number": "423-485-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2712 BENTON AVE",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374063620",
            "telephone_number": "423-876-5309",
            "fax_number": "423-485-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORD",
        "first_name": "CASSANDRA",
        "middle_name": "RENEE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2019-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "347E00000X",
            "taxonomy_group": "",
            "desc": "Transportation Broker",
            "state": "TN",
            "license": "065191300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.