Individual provider Active NPI

Ashley Ann Anklam Anderson, M.D.

  • Emergency Medicine Physician
  • New Prague, MN
National Provider Identifier
1063707461
Registry record updated Oct 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
63204 Issued in MN
Practice address
301 2ND St NE
New Prague, MN 56071-1709
Phone
(952) 758-4431
NPI assigned
Jun 14, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD-41649 IA
Emergency Medicine Physician 207P00000X 125.059418 IL
Emergency Medicine Physician 207P00000X 63204 MN Primary

Addresses

Primary practice location

301 2ND St NE
New Prague, MN 56071-1709

Mailing address

800 E 28TH St # Mr 11112
Minneapolis, MN 55407-3723
Phone (952) 239-5158

Other practice location 1

800 E 28th St # MR 11112
Minneapolis, MN 55407-3723
Phone (612) 863-6590

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aanderson363164@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180314001930 MN Practitioner - Emergency Medicine 7719106087 Reassigns benefits to 11 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD-41649IAMDEmergency Medicine Physician
125.059418ILMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Sep 12, 2022 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Sep 12, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jun 1, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jun 1, 2018 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic Health System-St James Current Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Sep 12, 2022 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Feb 18, 2019 Accepting new patients
Emergency Care Consultants, PA Emergency Medicine CurrentSince Apr 1, 2018 Accepting new patients
Allina Health System Past Accepting new patients
Ecc Addiction & Toxicology Services LLC Past Accepting new patients

Locations

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

200 State Ave
Faribault, MN 55021
Phone (507) 334-6451

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

800 E 28th St
#11112
Minneapolis, MN 55407
Phone (612) 863-4233

800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

2855 Campus Dr
Plymouth, MN 55441
Phone (763) 577-7000

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1308009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601942400000",
    "number": "1063707461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 28TH ST # MR 11112",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554073723",
            "telephone_number": "952-239-5158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 2ND ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709",
            "telephone_number": "952-758-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 E 28th St # MR 11112",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554073723",
            "country_code": "US",
            "telephone_number": "612-863-6590",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ASHLEY",
        "middle_name": "ANN ANKLAM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-14",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IA",
            "license": "MD-41649",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "125.059418",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MN",
            "license": "63204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aanderson363164@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "301 2nd St NE",
            "city": "New Prague",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560711709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in New Prague, MN

Sources for this page

Verify at the official NPI Registry.