Provider Demographics
NPI:1477692580
Name:CASSADY, PERRY B (MD)
Entity Type:Individual
Prefix:DR
First Name:PERRY
Middle Name:B
Last Name:CASSADY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 WHITTINGTON PKWY
Mailing Address - Street 2:SUITE 301
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4928
Mailing Address - Country:US
Mailing Address - Phone:502-625-5584
Mailing Address - Fax:502-426-2264
Practice Address - Street 1:1850 STATE ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-4990
Practice Address - Country:US
Practice Address - Phone:502-625-5584
Practice Address - Fax:502-426-2264
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30231207L00000X
IN01044743A207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000578181OtherONE NATIONAL BENEFIT
50023156OtherPASSPORT
INP00732466OtherRAILROAD MEDICARE
IN000000578181OtherANTHEM - MEDICAID
IN129703800OtherBLACK LUNG PROGRAM
3704441000OtherPASSPORT ADVANTAGE
KY64023138Medicaid
IN000000578181OtherUNICARE
KY000000578181OtherANTHEM
IN000000578181OtherINDIANA COMPREHENSIVE
IN000000578181OtherHEALTHLINK
IN200077180OtherMDWISE HOOSIER ALLIANCE
IN200077180Medicaid
IN000000578181OtherANTHEM SENIOR ADVANTAGE
IN000000578181OtherANTHEM
IN129703800OtherUS DEPT. OF LABOR
IN134960JOtherUNICARE-MEDICARE
IN200077180OtherMANAGED HEALTH SERVICES
IN200077180Medicaid