Individual provider Active NPI

Ashley R Killough, NURSE PRACTITIONER

  • Adult Health Nurse Practitioner
  • Jupiter, FL
National Provider Identifier
1083949879
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
ARNP9370915 Issued in FL
Practice address
500 University Blvd
Suite 208
Jupiter, FL 33458-2773
Phone
(561) 627-3130
NPI assigned
Oct 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5004480 NC
Adult Health Nurse Practitioner 363LA2200X ARNP9370915 FL Primary

Addresses

Primary practice location

500 University Blvd
Suite 208
Jupiter, FL 33458-2773

Mailing address

500 University Blvd
Suite 208
Jupiter, FL 33458-2773
Phone (508) 517-9403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20140310000697 FL Practitioner - Nurse Practitioner 0345402368 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5004480NCMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tenet Florida Physician Services LLC CurrentSince Jan 27, 2014 Accepting new patients
Tenet Florida Physician Services, LLC CurrentSince Jan 27, 2014 Accepting new patients

Locations

500 University Blvd
Ste 208
Jupiter, FL 33458
Phone (561) 624-5311

1411 N Flagler Dr
Ste 8000
West Palm Beach, FL 33401
Phone (561) 650-6231

Organizations & group practices 2

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": "1255305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1083949879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY BLVD",
            "address_2": "SUITE 208",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582773",
            "telephone_number": "508-517-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY BLVD",
            "address_2": "SUITE 208",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582773",
            "telephone_number": "561-627-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLOUGH",
        "first_name": "ASHLEY",
        "middle_name": "R",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-12",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5004480",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "FL",
            "license": "ARNP9370915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jupiter, FL

Sources for this page

Verify at the official NPI Registry.