Individual provider Active NPI

Ashleigh Nicole Haywood, PA-C

  • Physician Assistant
  • Bloomington, IN
National Provider Identifier
1174106520
Registry record updated Dec 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
10003119A Issued in IN
Practice address
1520 S Liberty Dr
Bloomington, IN 47403-5167
Phone
(812) 353-3700
NPI assigned
May 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003119A IN Primary

Addresses

Primary practice location

1520 S Liberty Dr
Bloomington, IN 47403-5167

Mailing address

250 N Shadeland Ave
Indianapolis, IN 46219-4959

Other names 1

  • Miss Ashleigh Nicole Poling Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ahaywood@direct.iuhealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20210917001546 IN Practitioner - Physician Assistant 2264839281 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Indiana University Health Southern Indiana Physicians LLCGroup PAC ID 6204748197, 474 clinicians
Iu Health Medical Group LLCGroup PAC ID 9638617913, 4,382 clinicians

Practice addresses (Care Compare)

1520 S Liberty Dr
Indiana University So in Phy Inc
Bloomington, IN 47403-5167
Phone (888) 484-3258

1701 N Senate Blvd
Indianapolis, IN 46202-1239
Phone (888) 484-3258

2209 John R Wooden Dr
Indiana University So in Phy Inc
Martinsville, IN 46151-1840
Phone (888) 484-3258

2651 E Discovery Pkwy
Bloomington, IN 47408-9059
Phone (812) 353-9250

2900 16TH St
Bedford, IN 47421-3510
Phone (888) 484-3258

707 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

719 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

727 W 2ND St
Bloomington, IN 47403-2209
Phone (888) 484-3258

Hospital & facility affiliations

  • Indiana University Health Bloomington Hospital Hospital, Bloomington, IN, CCN 150051
  • Indiana University Health Hospital, Indianapolis, IN, CCN 150056
  • Indiana University Health Bedford Hospital Hospital, Bedford, IN, CCN 151328
  • Indiana University Health Paoli Hospital Hospital, Paoli, IN, CCN 151306

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003119AINMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Indiana University Health Southern Indiana Physicians, LLC Physician Assistant CurrentSince Aug 23, 2021 Accepting new patients
Iu Health Medical Group, LLC Physician Assistant CurrentSince Jan 1, 2026 Accepting new patients
Indiana University Health Southern Indiana Physicians LLC CurrentSince Aug 23, 2021 Accepting new patients

Locations

1520 S Liberty Dr
Bloomington, IN 47403
Phone (812) 676-4300

727 W 2nd St
Bloomington, IN 47403
Phone (812) 353-3450

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

1701 Senate Blvd
Indianapolis, IN 46202
Phone (317) 612-2754

Interoperability endpoints

  • Direct secure messaging: ahaywood@direct.iuhealth.org

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 and National Provider Directory roles.

Hospital & facility affiliations 5

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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1174106520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 N SHADELAND AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462194959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1520 S LIBERTY DR",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035167",
            "telephone_number": "812-353-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYWOOD",
        "first_name": "ASHLEIGH",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-12-22",
        "certification_date": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003119A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahaywood@direct.iuhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1520 S Liberty Dr",
            "city": "Bloomington",
            "state": "IN",
            "country_code": "US",
            "postal_code": "474035167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ASHLEIGH",
            "last_name": "POLING",
            "middle_name": "NICOLE",
            "prefix": "MISS",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.