Healthcare Provider Details

I. General information

NPI: 1730726621
Provider Name (Legal Business Name): CASSADY REMY PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2019
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 THOMAS LN STE 3A
COLUMBUS OH
43214-1419
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-2500
  • Fax:
Mailing address:
  • Phone: 614-788-6010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number50.008748RX
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: