Individual provider Active NPI

Ashley Lynn Treadwell

  • Licensed Practical Nurse
  • Blue Point, NY
National Provider Identifier
1104365162
Registry record updated Feb 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
324480 Issued in NY
Practice address
263 Blue Point Ave
Blue Point, NY 11715-1224
Phone
(631) 419-6737
Fax
(631) 868-3498
NPI assigned
Feb 22, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 324480 NY Primary

Addresses

Primary practice location

263 Blue Point Ave
Blue Point, NY 11715-1224

Mailing address

90 Dog Wood LN
Wading River, NY 11792-1803
Phone (631) 680-1377

Other names 1

  • Ashley Lynn Brewer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
324480NYMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1487721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487721600000",
    "number": "1104365162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "90 DOG WOOD LN",
            "city": "WADING RIVER",
            "state": "NY",
            "postal_code": "117921803",
            "telephone_number": "631-680-1377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 BLUE POINT AVE",
            "city": "BLUE POINT",
            "state": "NY",
            "postal_code": "117151224",
            "telephone_number": "631-419-6737",
            "fax_number": "631-868-3498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADWELL",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-22",
        "last_updated": "2017-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "324480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "BREWER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blue Point, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.