Individual provider Active NPI

Ashley Witherspoon, DNP, FNP-BC

  • Family Nurse Practitioner
  • Placerville, CA
National Provider Identifier
1063100477
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95024916 Issued in CA
Practice address
4212 Missouri Flat Rd
Placerville, CA 95667-6269
Phone
(530) 621-7700
NPI assigned
Apr 25, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95024916 CA Primary

Addresses

Primary practice location

4212 Missouri Flat Rd
Placerville, CA 95667-6269

Mailing address

55 Fairview Ave # B
Chicopee, MA 01013-2919
Phone (413) 824-4513

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20240304000358 CA Order and Referring Only - Nurse Practitioner 3072958867

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
El Dorado County Community Health Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ashley.witherspoon@edchc.eclinicaldirectplus.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1063100477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FAIRVIEW AVE # B",
            "city": "CHICOPEE",
            "state": "MA",
            "postal_code": "010132919",
            "telephone_number": "413-824-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 MISSOURI FLAT RD",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956676269",
            "telephone_number": "530-621-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WITHERSPOON",
        "first_name": "ASHLEY",
        "credential": "DNP, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95024916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Placerville, CA

Sources for this page

Verify at the official NPI Registry.