Provider Demographics
NPI:1750538096
Name:THORPE, KASSY A (MD)
Entity type:Individual
Prefix:
First Name:KASSY
Middle Name:A
Last Name:THORPE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KASSY
Other - Middle Name:A
Other - Last Name:HEGGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1105 E HOLLY BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:SD
Practice Address - Zip Code:57005-1426
Practice Address - Country:US
Practice Address - Phone:605-582-5820
Practice Address - Fax:605-582-5823
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD8635208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAENROLLEDMedicaid
MNENROLLEDMedicaid
MN370003832Medicare PIN