Individual provider Active NPI

Ashley A McGuire, NP

  • Nurse Practitioner
  • Mequon, WI
National Provider Identifier
1174018584
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8478-033 Issued in WI
Practice address
12203 Corporate Pkwy
Mequon, WI 53092
Phone
(262) 387-8200
Fax
(262) 387-8239
NPI assigned
Jun 27, 2018
Last updated
Aug 21, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8478-033 WI Primary
Family Medicine Physician 207Q00000X 8478 WI

Addresses

Primary practice location

12203 Corporate Pkwy
Mequon, WI 53092

Mailing address

12203 Corporate Pkwy
Mequon, WI 53092-3388
Phone (262) 387-8200

Other identifiers 1

IdentifierTypeStateIssuer
100079172MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180731004147 WI Practitioner - Nurse Practitioner 2163770637

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

122 Green Bay Rd
Thiensville, WI 53092-1679

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8478WIMDFamily Medicine Physician
8478-033WIMDNurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566345600000",
    "number": "1174018584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12203 CORPORATE PKWY",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530923388",
            "telephone_number": "262-387-8200",
            "fax_number": "262-387-8239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12203 CORPORATE PKWY",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "53092",
            "telephone_number": "262-387-8200",
            "fax_number": "262-387-8239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGUIRE",
        "first_name": "ASHLEY",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-27",
        "last_updated": "2019-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WI",
            "license": "8478-033",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WI",
            "license": "8478",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100079172",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

Verify at the official NPI Registry.