Individual provider Active NPI

Ashlee A Secret, MD

  • Family Medicine Physician
  • Bridgeport, WV
National Provider Identifier
1164684346
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
24289 Issued in WV
Practice address
527 Medical Park Dr
Suite 500
Bridgeport, WV 26330-9007
Phone
(681) 342-3600
Fax
(681) 342-3625
NPI assigned
Jun 27, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 24289 WV Primary

Addresses

Primary practice location

527 Medical Park Dr
Suite 500
Bridgeport, WV 26330-9007

Mailing address

527 Medical Park Dr
Suite 500
Bridgeport, WV 26330-9007
Phone (681) 342-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170321000542 WV Order and Referring Only - Family PracticePractitioner - Family Practice 6709058340

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1214524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1164684346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR",
            "address_2": "SUITE 500",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309007",
            "telephone_number": "681-342-3600",
            "fax_number": "681-342-3625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 MEDICAL PARK DR",
            "address_2": "SUITE 500",
            "city": "BRIDGEPORT",
            "state": "WV",
            "postal_code": "263309007",
            "telephone_number": "681-342-3600",
            "fax_number": "681-342-3625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SECRET",
        "first_name": "ASHLEE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-27",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "24289",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, WV

Sources for this page

Verify at the official NPI Registry.