Individual provider Active NPI

Ashley Wilson

  • Family Nurse Practitioner
  • Austin, TX
National Provider Identifier
1114610219
Registry record updated Jun 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1123564 Issued in TX
Practice address
12221 N Mopac Expy
Austin, TX 78758-2401
Phone
(512) 901-1000
NPI assigned
Jun 2, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1123564 TX Primary
Family Nurse Practitioner 363LF0000X F04230330 TX

Addresses

Primary practice location

12221 N Mopac Expy
Austin, TX 78758-2401

Mailing address

440 Holly Grove St
Kyle, TX 78640-5534
Phone (214) 603-6485

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
1123564TXMDFamily Nurse Practitioner
F04230330TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Texas Two Medical Group, PLLC Past Accepting new patients

Organizations & group practices 1

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": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1114610219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 HOLLY GROVE ST",
            "city": "KYLE",
            "state": "TX",
            "postal_code": "786405534",
            "telephone_number": "214-603-6485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12221 N MOPAC EXPY",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787582401",
            "telephone_number": "512-901-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "ASHLEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1123564",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "F04230330",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.