MR. TIMOTHY PAUL CASSIDY JR. (NPI# 1841760816) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841760816 |
| Entity Type | Individual |
| Full Name | MR. TIMOTHY PAUL CASSIDY JR. |
| Credential | NP-C |
| Practice Address |
289 Sw Stonegate Ter Ste 103 Lake City FL 32024-3457 |
| Mailing Address |
263 Sw Professional Gln Lake City FL 32025-1105 |
| Practice Telephone | 3867551655 |
| Practice Fax Number | 3867552330 |
| Mailing Telephone | 3864385722 |
| Mailing Fax Number | 3864388631 |
| Enumeration Date | 2018-12-03 |
| Last Update Date | 2020-08-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
APRN9227994 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | PENDING | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750948287 | Timothy Cassidy | Physician Assistant | 6801 Lilac Dr Apt A, Lockport, NY 14094-6824 | 2019-05-20 |
| 1861465445 | Timothy Dennis Cassidy | Internal Medicine | 2200 Bergquist Dr, Attn: Credentials (cms), Lackland A F B, TX 78236-9907 | 2006-02-13 |
| Street Address |
289 SW STONEGATE TER STE 103 |
| City | LAKE CITY |
| State | FL |
| Zip Code | 32024-3457 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083170534 | Sf Brevard, LLC | Skilled Nursing Facility | 298 Sw Prosperity Place, Lake City, FL 32024 | 2019-02-20 |
| 1689103079 | Vivian Robinson | Driver | 133 Sw Maereatha Ct, Lake City, FL 32024 | 2017-06-08 |
| 1508014630 | Stephen Lewis O'steen | Physical Therapy Assistant | 146 Sw Orthopaedic Court, Lake City, FL 32024 | 2008-09-03 |
| 1598965634 | Lake City Surgery Center, LLC | Clinic/Center | 208 Sw Prosperity Place, Lake City, FL 32024 | 2007-07-18 |
| 1932308145 | Smile Designs By Charlotte Gerry | Dentist | 857 Sw Main Blvd, Suite 105, Lake City, FL 32024 | 2007-07-17 |
| 1790900447 | Leopold Bejamin Leblique | General Practice | 264 Sw Ridgeview Pl., Lake City, FL 32024 | 2007-04-16 |
| 1073785911 | Rescare, Inc. | Intermediate Care Facility, Mentally Retarded | 1403 Spring St, Lake City, FL 32024 | 2008-04-01 |
| 1124202502 | Christina Mcghghy | Physical Therapy Assistant | 289 Sw Stonegate Terr, Suite #101, Lake City, FL 32024 | 2007-12-21 |
| 1629682133 | Paula Carol Palmer | Registered Nurse | 3857 Sw Birley Ave, Lake City, FL 32024-0003 | 2020-09-02 |
| 1831635176 | Patricia Vance | Chore Provider | 2238 Sw Salem Rd, Lake City, FL 32024-0029 | 2017-01-10 |
| Find all providers in zip 32024 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841611407 | Magnolia Adult | Nurse Practitioner | 1211 Sw Bascom Norris Dr Ste 201, Lake City, FL 32025-4916 | 2013-12-30 |
| 1033477567 | Magnolia Adult | Nurse Practitioner | 1140 Sw Bascom Norris Dr Ste 105, Lake City, FL 32025-1329 | 2012-05-03 |
| 1619293867 | Jennifer Goolsby Watson | Nurse Practitioner | 2970 W Us Highway 90, Suite 120, Lake City, FL 32055-4700 | 2010-04-13 |
| 1831266394 | Elizabeth Teuscher Beardsley | Nurse Practitioner | 204 Nw Emporia Gln, Lake City, FL 32055-8516 | 2006-11-29 |
| 1861018988 | Tymber Tatum Terrell | Nurse Practitioner | 410 Sw Silver Palm Dr, Lake City, FL 32024-6757 | 2020-06-24 |
| 1942706452 | Ariel Parnell | Nurse Practitioner | 4367 Nw American Ln, Lake City, FL 32055-4828 | 2018-04-03 |
| 1821538315 | Stephanie Sapp | Nurse Practitioner | 1531 Sw Commercial Gln, Lake City, FL 32025-0454 | 2017-03-02 |
| 1023550696 | Antranika D. Ross | Nurse Practitioner | 2055 Rex Rd, Lake City, GA 30260-3944 | 2016-11-13 |
| 1164769675 | Florida Dermcare, Inc. | Nurse Practitioner | 204 Nw Emporia Gln, Lake City, FL 32055-8516 | 2013-01-04 |
| 1306097076 | Tonna Jeanette Sotolongo | Nurse Practitioner | 619 S Marion Ave, Lake City, FL 32025-5808 | 2008-09-30 |
| Find all providers in LAKE CITY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.