Individual provider Active NPI

Cassondra Marie Larsen, CNM

  • Midwife
  • Hagerstown, MD
National Provider Identifier
1992323604
Registry record updated Nov 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
MidwifeTaxonomy code 176B00000X
License
R201221 Issued in MD
Practice address
1165 Imperial Dr Ste 300
Hagerstown, MD 21740-6556
Phone
(301) 665-9098
Fax
(301) 665-9096
NPI assigned
Jul 9, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X R201221 MD Primary

Addresses

Primary practice location

1165 Imperial Dr Ste 300
Hagerstown, MD 21740-6556

Mailing address

8110 Maple Lawn Blvd Ste 235
Fulton, MD 20759-2694
Phone (301) 340-8339

Other identifiers 2

IdentifierTypeStateIssuer
R201221OtherMDLICENSE
ASC-197ZMedicaidMD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cassondra.larsen.p1@direct.cwcare.nextgenshare.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

State licenses

LicenseStateTypeSpecialty
R201221MDMDMidwife

Practice roles

OrganizationSpecialtyStatusNew patients
Capital Women'S Care, L.L.C. Current Accepting new patients
Capital Women'S Care, L.L.C. CurrentSince Oct 1, 2020 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

61 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 663-6171

8110 Maple Lawn Blvd
Ste 235
Fulton, MD 20759

1165 Imperial Dr
Ste 300
Hagerstown, MD 21740
Phone (301) 665-9098

Interoperability endpoints

  • Direct secure messaging: cassondra.larsen.p1@direct.cwcare.nextgenshare.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1594252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1992323604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8110 MAPLE LAWN BLVD STE 235",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592694",
            "telephone_number": "301-340-8339",
            "fax_number": "301-340-8339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1165 IMPERIAL DR STE 300",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217406556",
            "telephone_number": "301-665-9098",
            "fax_number": "301-665-9096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARSEN",
        "first_name": "CASSONDRA",
        "middle_name": "MARIE",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-09",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "MD",
            "license": "R201221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "R201221",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ASC-197Z",
            "state": "MD"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cassondra.larsen.p1@direct.cwcare.nextgenshare.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1165 Imperial Dr Ste 300",
            "city": "Hagerstown",
            "state": "MD",
            "country_code": "US",
            "postal_code": "217406556",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.