Individual provider Active NPI

Cassidy Brooke Simoneaux, DO

  • Pediatrics Physician
  • Kannapolis, NC
National Provider Identifier
1992455034
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
2025-02934 Issued in NC
Practice address
3396 Cloverleaf Pkwy
Kannapolis, NC 28083-6992
Phone
(704) 403-7740
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 2025-02934 NC Primary

Addresses

Primary practice location

3396 Cloverleaf Pkwy
Kannapolis, NC 28083-6992

Mailing address

3826 Isenhour Rd
Kannapolis, NC 28081-7400
Phone (704) 231-5789

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221208000720 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 1557730843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2025-02934NCMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network, Inc Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: csimoneaux915263@carolinashealthcaresystem.direct-ci.com

Organizations & group practices 1

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1992455034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3826 ISENHOUR RD",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280817400",
            "telephone_number": "704-231-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3396 CLOVERLEAF PKWY",
            "city": "KANNAPOLIS",
            "state": "NC",
            "postal_code": "280836992",
            "telephone_number": "704-403-7740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONEAUX",
        "first_name": "CASSIDY",
        "middle_name": "BROOKE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2025-02934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kannapolis, NC

Sources for this page

Verify at the official NPI Registry.