Cassidy Connett Beall, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

5017110 Issued in NC

Practice address

1124 Gallery Park Blvd
Wilmington, NC 28412-1142

Phone

(910) 343-1031

Fax

(910) 251-8896

NPI assigned

Mar 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Cassidy Marie Connett Former name

Medicare fee-for-service enrollment

Enrolled in CO, NC2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Wilmington Health PLLC 364 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cassidy.beall.p1@direct.wilmingtonhealth.nextgenshare.com

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.

• Wilmington Health PLLC

  • Multi-Specialty Clinic/Center
  • Wilmington, NC
  • NPI 1881632339

  NC

  Medicare reassignment Care Compare group NPD
• Wilmington ASC LLC

  • Ambulatory Surgical Clinic/Center
  • Wilmington, NC
  • NPI 1548456478
  NPD
• Wilmington Health PLLC

  • Non-Pharmacy Dispensing Site
  • Wilmington, NC
  • NPI 1851054803
  NPD
• Portercare Adventist Health System

  • Internal Medicine Physician
  • Denver, CO
  • NPI 1497992713
  NPD
• Portercare Adventist Health System

  • Otolaryngology Physician
  • Greenwood Village, CO
  • NPI 1760761928
  NPD
• Portercare Adventist Health System

  • Urology Physician
  • Lakewood, CO
  • NPI 1942165626
  NPD

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

{
    "created_epoch": "1552348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685059200000",
    "number": "1992264626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 MEDICAL CENTER DR",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017307",
            "telephone_number": "910-617-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1124 GALLERY PARK BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284121142",
            "telephone_number": "910-343-1031",
            "fax_number": "910-251-8896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEALL",
        "first_name": "CASSIDY",
        "middle_name": "CONNETT",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-12",
        "last_updated": "2023-05-26",
        "certification_date": "2023-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "APN.0994155-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "15743457",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5017110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000171155",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CASSIDY",
            "last_name": "CONNETT",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Beacon of Hope Counseling, PLLC
• Isabel Beadore
• Amy Beahan
• Beall Hearing Solutions, LLC.
• Alexandra N Beall, BC-HIS
• Nicholas Yearick Beall, H.I.S.
• Anne Y Beam, MD
• William Moore Beam II, M.D.
• Elizabeth Beamer
• Allison Belle Bean, M.D.

• All providers in Wilmington, NC
• Family Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2023; 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.