Individual provider Active NPI

Ashley Ryan Glenn-McDowell, MS, PA-C

  • Medical Physician Assistant
  • Colton, CA
National Provider Identifier
1063859783
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA23190 Issued in CA
Practice address
400 N Pepper Ave
Mob Suite 107
Colton, CA 92324-1801
Phone
(909) 580-2178
NPI assigned
Jun 4, 2013
Last updated
Sep 25, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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 PA23190 CA Primary

Addresses

Primary practice location

400 N Pepper Ave
Mob Suite 107
Colton, CA 92324-1801

Mailing address

400 N Pepper Ave
Mob Suite 107
Colton, CA 92324-1801
Phone (909) 580-2178

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
I20131227000731 CA Practitioner - Physician Assistant 3274760061 Reassigns benefits to 5 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA23190CAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America-California CurrentSince Jan 1, 2014 Accepting new patients
Cep America - California CurrentSince Jan 1, 2014 Accepting new patients
Cep America - California CurrentSince Jan 1, 2014 Accepting new patients

Locations

600 N Highland Springs Ave
Banning, CA 92220
Phone (833) 443-6287

2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000

400 N Pepper Ave
Ste 107
Colton, CA 92324
Phone (909) 580-1862

800 S Main St
Corona, CA 92882
Phone (909) 625-5411

31872 Coast Hwy
Laguna Beach, CA 92651
Phone (949) 499-1311

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1798 N Garey Ave
Pomona, CA 91767
Phone (909) 865-9810

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.

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1063859783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "MOB SUITE 107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-2178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N PEPPER AVE",
            "address_2": "MOB SUITE 107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923241801",
            "telephone_number": "909-580-2178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLENN-MCDOWELL",
        "first_name": "ASHLEY",
        "middle_name": "RYAN",
        "name_prefix": "Mrs.",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA23190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colton, CA

Sources for this page

Verify at the official NPI Registry.