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CASSIDY REDSHAW
NPI 1639883168
Counselor - Mental Health in Jacksonville, FL

Active since January 10, 2023PECOS Enrolled
5300 SAN JUAN AVE, JACKSONVILLE, FL 32210(904) 738-8579 Get Directions Write a Review

NPPES record last updated: January 10, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Cassidy Redshaw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CASSIDY REDSHAW (NPI 1639883168) is an individual mental health provider in Jacksonville, Florida and active in the NPI registry since January 2023. She is enrolled in Medicare PECOS and is a graduate of Other (2023).

NPPES Registry Identity

NPI1639883168
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameCASSIDY REDSHAW
Location Address5300 SAN JUAN AVEJacksonville, FL 32210-3142
Mailing Address3867 Buckskin Trl EJacksonville, FL 32277-2229
Phone(904) 738-8579
Sole ProprietorNo
Medical School CMSOtherGraduated 2023
Enumeration DateJanuary 10, 2023
NPPES CertifiedJanuary 9, 2023
✔ NPI 1639883168 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5300 SAN JUAN AVE, Jacksonville, FL 32210
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Cassidy Redshaw is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID2466921192
PECOS Enrollment IDI20260512002130
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

FIRST COAST COMMUNITY SUPPORT SERVICES
Community/Behavioral Health
5300 SAN JUAN AVE
JACKSONVILLE, FL 32210
Duval County (904) 738-8579
NURSING ON DEMAND INC
Technician (Attendant Care Provider)
5300 SAN JUAN AVE
JACKSONVILLE, FL 32210
Duval County (904) 387-9406

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Cassidy Redshaw's NPI number?

The NPI number for Cassidy Redshaw is 1639883168. It was assigned to this individual provider in the NPPES registry on January 10, 2023.

Where is Cassidy Redshaw located?

Cassidy Redshaw practices at 5300 San Juan Ave, Jacksonville, FL 32210. The listed phone number is (904) 738-8579.

What is Cassidy Redshaw's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Cassidy Redshaw enrolled in Medicare?

Yes. Cassidy Redshaw is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Cassidy Redshaw was last updated on January 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.