Individual provider Active NPI

Ashlie Danielle Vasquez

  • Speech-Language Pathologist
  • Anthony, NM
National Provider Identifier
1164961983
Registry record updated Jun 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
114377 Issued in TX
Practice address
875 Mercantil Ave
Anthony, NM 88021
Phone
(575) 874-3592
NPI assigned
Feb 13, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 18, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X C-6123 NM
Speech-Language Pathologist 235Z00000X 114377 TX Primary

Addresses

Primary practice location

875 Mercantil Ave
Anthony, NM 88021

Mailing address

PO Drawer70
Medicaid Dept
Anthony, NM 88021
Phone (575) 882-6101

Other names 1

  • Ashlie Danielle Mena 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
C-6123NMMDSpeech-Language Pathologist
114377TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Gadsden Independent School District 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": "1486944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529280000000",
    "number": "1164961983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER70",
            "address_2": "MEDICAID DEPT",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "88021",
            "telephone_number": "575-882-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MERCANTIL AVE",
            "city": "ANTHONY",
            "state": "NM",
            "postal_code": "88021",
            "telephone_number": "575-874-3592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASQUEZ",
        "first_name": "ASHLIE",
        "middle_name": "DANIELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-13",
        "last_updated": "2018-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NM",
            "license": "C-6123",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "114377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLIE",
            "last_name": "MENA",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anthony, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2018; 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.