Individual provider Active NPI

Ashley Fagan

  • Home Health Registered Nurse
  • Lake Saint Louis, MO
National Provider Identifier
1134036015
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health Registered NurseTaxonomy code 163WH0200X
License
2017021347 Issued in MO
Practice address
1328 Flintshire LN
Lake Saint Louis, MO 63367-1949
Phone
(573) 768-6345
NPI assigned
Aug 26, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 2017021347 MO Primary

Addresses

Primary practice location

1328 Flintshire LN
Lake Saint Louis, MO 63367-1949

Mailing address

1328 Flintshire LN
Lake Saint Louis, MO 63367-1949
Phone (573) 768-6345

Other names 1

  • Ashley Moll Former name

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1787702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1134036015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1328 FLINTSHIRE LN",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671949",
            "telephone_number": "573-768-6345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1328 FLINTSHIRE LN",
            "city": "LAKE SAINT LOUIS",
            "state": "MO",
            "postal_code": "633671949",
            "telephone_number": "573-768-6345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAGAN",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-08-26",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MO",
            "license": "2017021347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MOLL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lake Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.