Individual provider Active NPI

Ashley Talisa Christian

  • Psychiatric/Mental Health Nurse Practitioner
  • Poplar Bluff, MO
National Provider Identifier
1073070702
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2023010529 Issued in MO
Practice address
3001 Warrior LN
Poplar Bluff, MO 63901-8685
Phone
(573) 686-1200
NPI assigned
Feb 28, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 897667 MS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 904491 MS
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1-183314 AL
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2023010529 MO Primary

Addresses

Primary practice location

3001 Warrior LN
Poplar Bluff, MO 63901-8685

Mailing address

5001 Warrior LN
Poplar Bluff, MO 63901
Phone (573) 686-1200

Other practice location 1

1600 7th Ave S
Birmingham, AL 35233-1711
Phone (205) 638-9100

Other practice location 2

5000 Highway 39 N
Meridian, MS 39301-1021
Phone (601) 483-6211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210423001144 MS Practitioner - Nurse Practitioner 1355759721 Reassigns benefits to 1 organization
I20230501000065 MO Practitioner - Nurse Practitioner 1355759721 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Counseling Center IncGroup PAC ID 2163410481, 39 clinicians

Practice addresses (Care Compare)

3001 Warrior LN
Poplar Bluff, MO 63901-8685
Phone (573) 686-1200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
897667MSMDRegistered Nurse
1-183314ALMDPsychiatric/Mental Health Nurse Practitioner
2023010529MOMDPsychiatric/Mental Health Nurse Practitioner
904491MSMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Right Track Medical Group, Inc CurrentSince Mar 1, 2021 Accepting new patients
Family Counseling Center, Inc. CurrentSince Apr 10, 2023 Accepting new patients
Family Counseling Center, Inc. CurrentSince Apr 10, 2023 Accepting new patients

Locations

20 S Sprigg St
Cape Girardeau, MO 63703
Phone (573) 651-4177

915 Highway 84 W
Caruthersville, MO 63830
Phone (573) 333-5975

910 Truman Blvd
Caruthersville, MO 63830
Phone (573) 333-5202

315 E Walnut St
Ellington, MO 63638
Phone (573) 663-2500

500 State Highway J
Hayti, MO 63851
Phone (573) 359-9840

1109 Jones St
Kennett, MO 63857
Phone (573) 888-6454

5 Sugar Creek Rd
Piedmont, MO 63957
Phone (573) 223-4169

3001 Warrior Ln
Poplar Bluff, MO 63901
Phone (573) 785-7453

1015 Lanton Rd
West Plains, MO 65775
Phone (417) 256-2570

3411 Division Dr
West Plains, MO 65775
Phone (417) 257-9152

1203 Medical Park Dr
Oxford, MS 38655
Phone (662) 513-4399

200 Highway 12 E
Starkville, MS 39759
Phone (662) 498-1900

Organizations & group practices 3

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": "1551312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1073070702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "63901",
            "telephone_number": "573-686-1200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 WARRIOR LN",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639018685",
            "telephone_number": "573-686-1200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 7th Ave S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331711",
            "country_code": "US",
            "telephone_number": "205-638-9100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5000 Highway 39 N",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "MS",
            "postal_code": "393011021",
            "country_code": "US",
            "telephone_number": "601-483-6211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTIAN",
        "first_name": "ASHLEY",
        "middle_name": "TALISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-28",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MS",
            "license": "897667",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MS",
            "license": "904491",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AL",
            "license": "1-183314",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2023010529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poplar Bluff, MO

Sources for this page

Verify at the official NPI Registry.