Individual provider Active NPI

Ashley S Underwood

  • Family Nurse Practitioner
  • Jefferson, GA
National Provider Identifier
1124453212
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
192047 Issued in GA
Practice address
1496 Winder Hwy Ste 105
Jefferson, GA 30549-5468
Phone
(770) 848-9456
NPI assigned
Sep 7, 2013
Last updated
Jan 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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 192047 GA Primary

Addresses

Primary practice location

1496 Winder Hwy Ste 105
Jefferson, GA 30549-5468

Mailing address

PO Box 742616
Atlanta, GA 30374-2616
Phone (770) 219-8420

Other practice location 1

3331 Hamilton Mill Rd
Buford, GA 30519-4096
Phone (678) 541-0588

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address aunderwood154750@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20141013001486 GA Practitioner - Nurse Practitioner 1658591706 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Georgia Physicians Group Urgent Care LLCGroup PAC ID 3274535687, 62 clinicians

Practice addresses (Care Compare)

1496 Winder Hwy
Suite 105
Jefferson, GA 30549-5468
Phone (770) 848-9456

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
192047GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
TLC of Georgia LLC Family CurrentSince Jul 7, 2015 Accepting new patients
Northeast Georgia Physicians Group Urgent Care LLC CurrentSince Sep 15, 2022 Accepting new patients
Northeast Georgia Physicians Group Inc PastSince Sep 15, 2022 Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

73 Maxwell Ln
Dahlonega, GA 30533
Phone (706) 344-6953

455 Nathan Dean Blvd
Dallas, GA 30132
Phone (770) 443-8776

1496 Winder Hwy
Ste 105
Jefferson, GA 30549
Phone (770) 848-5400

3600 Dallas Hwy SW
Marietta, GA 30064
Phone (770) 420-9170

6001 Cumming Hwy
Ste 1
Sugar Hill, GA 30518
Phone (678) 546-4062

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 1

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": "1378512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1124453212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742616",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742616",
            "telephone_number": "770-219-8420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1496 WINDER HWY STE 105",
            "city": "JEFFERSON",
            "state": "GA",
            "postal_code": "305495468",
            "telephone_number": "770-848-9456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3331 Hamilton Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305194096",
            "country_code": "US",
            "telephone_number": "678-541-0588",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNDERWOOD",
        "first_name": "ASHLEY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-07",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "192047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aunderwood154750@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1496 Winder Hwy Ste 105",
            "city": "Jefferson",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305495468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Jefferson, GA

Sources for this page

Verify at the official NPI Registry.