Individual provider Active NPI

Ashley Owens, PA-C

  • Medical Physician Assistant
  • Reno, NV
National Provider Identifier
1033663265
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA1770 Issued in NV
Practice address
975 Ryland St Ste 100
Reno, NV 89502-1669
Phone
(775) 982-5000
Fax
(775) 982-5225
NPI assigned
Aug 4, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA1770 NV Primary

Addresses

Primary practice location

975 Ryland St Ste 100
Reno, NV 89502-1669

Mailing address

640 W Moana LN
Reno, NV 89509-4903
Phone (775) 324-0699

Other identifiers 1

IdentifierTypeStateIssuer
PA1770OtherNVPA-C LICENSURE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161014001671 NV Practitioner - Physician Assistant 8325336845 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Derm - Blackhart PLLCGroup PAC ID 1153609813, 103 clinicians

Practice addresses (Care Compare)

3640 Warren Way
Reno, NV 89509-5240
Phone (775) 324-0699

9672 S McCarran Blvd
Reno, NV 89523-9205
Phone (775) 324-0699

Hospital & facility affiliations

  • Renown Regional Medical Center Hospital, Reno, NV, CCN 290001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA1770NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Derm-Blackhart, PLLC CurrentSince Aug 1, 2021 Accepting new patients
Skin Cancer and Dermatology Institute Current Accepting new patients
Mountain West Derm - Blackhart PLLC CurrentSince Aug 1, 2021 Accepting new patients

Locations

3640 Warren Way
Ste 100
Reno, NV 89509

640 W Moana Ln
Reno, NV 89509
Phone (775) 882-8777

Interoperability endpoints

  • Direct secure messaging: aowens1@skincancerderm.emadirect.md

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1470268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1033663265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "640 W MOANA LN",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895094903",
            "telephone_number": "775-324-0699",
            "fax_number": "775-323-6814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 RYLAND ST STE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021669",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-04",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA1770",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PA-C LICENSURE",
            "identifier": "PA1770",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Reno, NV

Sources for this page

Verify at the official NPI Registry.