NPIMap

Individual provider Active NPI

Ashley Souders

  • Certified Registered Nurse Anesthetist
  • Grand Forks, ND
National Provider Identifier
1063199479
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
10032561 Issued in OR
Practice address
430 Oxford St
Grand Forks, ND 58202-6092
Phone
(701) 777-4174
NPI assigned
Jun 28, 2023
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 10032561 OR Primary
Registered Nurse 163W00000X R51326 ND

Addresses

Primary practice location

430 Oxford St
Grand Forks, ND 58202-6092

Mailing address

734 Great Plains CT
Grand Forks, ND 58201-7248
Phone (727) 459-8625

Other practice location 1

1046 6th Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address asouders306256@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241001000825 OR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911438049 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Albany General HospitalGroup PAC ID 9931097987, 191 clinicians
Mid-Valley Healthcare IncGroup PAC ID 2769391523, 143 clinicians

Practice addresses (Care Compare)

1046 6TH Ave SW
Albany, OR 97321-1916
Phone (541) 812-4000

325 Park St
Lebanon, OR 97355-4229
Phone (541) 451-7200

525 N Santiam Hwy
Lebanon, OR 97355-4363
Phone (541) 258-2101

705 Elm St SW
Suite 200
Albany, OR 97321-1957
Phone (541) 812-4850

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R51326NDMDRegistered Nurse
10032561ORMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Albany General Hospital CurrentSince Oct 28, 2024 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Oct 28, 2024 Accepting new patients
Albany General Hospital CurrentSince Oct 28, 2024 Accepting new patients
Mid-Valley Healthcare Inc Current Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 28, 2024 Accepting new patients
Good Samaritan Hospital Corvallis CurrentSince Oct 28, 2024 Accepting new patients
Mid-Valley Healthcare Inc CurrentSince Oct 28, 2024 Accepting new patients
Good Samaritan Hospital Corvallis Current Accepting new patients

Locations

1046 6th Ave SW
Albany, OR 97321
Phone (541) 812-4000

705 Elm St SW
Ste 200
Albany, OR 97321
Phone (541) 812-4850

3600 NW Samaritan Dr
Ste 227
Corvallis, OR 97330
Phone (541) 768-1261

815 NW 9th St
Ste 215
Corvallis, OR 97330
Phone (541) 768-1888

325 Park St
Lebanon, OR 97355
Phone (541) 451-7200

Interoperability endpoints

  • Direct secure messaging: asouders306256@samhealth.direct-ci.com

Organizations & group practices 8

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

Hospital & facility affiliations 32

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

View all 32

NPI Registry JSON

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1063199479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "734 GREAT PLAINS CT",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582017248",
            "telephone_number": "727-459-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 OXFORD ST",
            "city": "GRAND FORKS",
            "state": "ND",
            "postal_code": "582026092",
            "telephone_number": "701-777-4174"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1046 6th Ave SW",
            "address_purpose": "LOCATION",
            "city": "Albany",
            "state": "OR",
            "postal_code": "973211916",
            "country_code": "US",
            "telephone_number": "541-812-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SOUDERS",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OR",
            "license": "10032561",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "ND",
            "license": "R51326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "asouders306256@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "1046 6th Ave SW",
            "city": "Albany",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973211916",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Grand Forks, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.