Ashley De Witt, DO
Individual provider Active NPI Obstetrics & Gynecology Physician · Winchester, TN
NPI 1043476757 · NPPES record last updated Nov 8, 2024
Key facts
- NPI
- 1043476757
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 2396 (TN)
- Practice address
- 155 Hospital Rd Ste C
Winchester, TN 37398-2495 - Phone
- (931) 962-3297
- Fax
- (931) 967-0175
- NPI assigned
- Aug 1, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 11
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Obstetrics/Gynecology
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Amg-Southern Tennessee LLC
Practice addresses (Care Compare)
155 Hospital Rd
Suite C
Winchester, TN 37398-2495
Phone (931) 967-8111
Hospital & facility affiliations
- Southern Tennessee Regional Health System Winchest
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121024000729 | TN | Practitioner - Obstetrics/Gynecology | 2062662265 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2396 | TN | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amg-Southern Tennessee LLC | Current |
Accepting new patients | |
| Amg-Southern Tennessee LLC | Current |
Accepting new patients | |
| Southern Tennessee Medical Center LLC | Past | Accepting new patients | |
| Amg -Southern Tennessee LLC | Past | Accepting new patients |
Locations
1610 McArthur St
Manchester, TN 37355
Phone (931) 954-5111
83 Memorial Dr
Winchester, TN 37398
Phone (931) 967-3966
155 Hospital Rd
Ste C
Winchester, TN 37398
Phone (931) 962-3297
161 Shirley Dr
Winchester, TN 37398
Phone (931) 962-0450
Interoperability endpoints
- ashley.dewitt.1@19363.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Obstetrics & Gynecology Physician | 207V00000X | 2396 | TN | Yes |
Addresses
Primary practice location
155 Hospital Rd Ste C
Winchester, TN 37398-2495
Mailing address
155 Hospital Rd Ste C
Winchester, TN 37398-2495
Phone (931) 962-3297
Other providers in Winchester, TN
- Cumberland Lung Specialists
- Cumberland Neurology, LLC
- Tiffany Michelle Curtis
- Gina M Dado
- Cadence Nariah Dawson
- Anna Morgan Delucenay
- Dialysis Associates, LLC
- Jonathan Diggs
- Meredith Joy Dixon
- Dr Eckard MD
All providers in Winchester, TN · Obstetrics & Gynecology Physician in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 8, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.