NPIMap

Individual provider Active NPI

Ashley Nicole Huddlestun, FNP-BC

  • Family Nurse Practitioner
  • Mattoon, IL
National Provider Identifier
1083339642
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
041457073 Issued in IL
Practice address
911 Remington Rd Ste B
Mattoon, IL 61938-4210
Phone
(217) 234-3091
Fax
(217) 234-3094
NPI assigned
Oct 6, 2022
Last updated
Apr 24, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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 041457073 IL Primary

Addresses

Primary practice location

911 Remington Rd Ste B
Mattoon, IL 61938-4210

Mailing address

911 Remington Rd Ste B
Mattoon, IL 61938-4210
Phone (217) 234-3091

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ashley.huddlestun.1@9559.direct.athenahealth.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231219002984 IL Practitioner - Nurse Practitioner 1153771035 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

911 Remington Rd
Suite B
Mattoon, IL 61938-4210
Phone (217) 234-3091

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
041457073ILMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Healthcare Foundation, Inc. Family Medicine CurrentSince Apr 19, 2024 Accepting new patients
Southern Illinois Healthcare Foundation Inc Family Medicine Current Accepting new patients
Southern Illinois Healthcare Foundation Inc CurrentSince Apr 19, 2024 Accepting new patients

Locations

302 N Mill St
Greenup, IL 62428
Phone (217) 923-3311

911 Remington Rd
Ste B
Mattoon, IL 61938
Phone (217) 234-3091

2041 Goose Lake Rd
Sauget, IL 62206

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1083339642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 REMINGTON RD STE B",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384210",
            "telephone_number": "217-234-3091",
            "fax_number": "217-234-3094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 REMINGTON RD STE B",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384210",
            "telephone_number": "217-234-3091",
            "fax_number": "217-234-3094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUDDLESTUN",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-06",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "041457073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ashley.huddlestun.1@9559.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "911 Remington Rd Ste B",
            "city": "Mattoon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "619384210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

Verify at the official NPI Registry.