Individual provider Active NPI

Kerianne D Cassesso, RN

  • Registered Nurse
  • Peabody, MA
National Provider Identifier
1982886941
Registry record updated Dec 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
257439 Issued in MA
Practice address
64 Foster St
Unit 406
Peabody, MA 01960-5948
Phone
(978) 430-6933
NPI assigned
Dec 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 3, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 257439 MA Primary

Addresses

Primary practice location

64 Foster St
Unit 406
Peabody, MA 01960-5948

Mailing address

64 Foster St
Unit 406
Peabody, MA 01960-5948
Phone (978) 430-6933

Other identifiers 1

IdentifierTypeStateIssuer
0713201OtherMAMASSHEALTH

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
257439MAMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1196640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1982886941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 FOSTER ST",
            "address_2": "UNIT 406",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605948",
            "telephone_number": "978-430-6933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 FOSTER ST",
            "address_2": "UNIT 406",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019605948",
            "telephone_number": "978-430-6933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASSESSO",
        "first_name": "KERIANNE",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-03",
        "last_updated": "2007-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MA",
            "license": "257439",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSHEALTH",
            "identifier": "0713201",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.