Individual provider Active NPI

Angela Jean Ashman II

  • Registered Nurse
  • Kaukauna, WI
National Provider Identifier
1174775506
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
162885-30 Issued in WI
Practice address
1981 Greengrove St
Kaukauna, WI 54130-3921
Phone
(920) 759-4436
NPI assigned
Oct 16, 2008
Last updated
Jul 29, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 162885-30 WI Primary

Addresses

Primary practice location

1981 Greengrove St
Kaukauna, WI 54130-3921

Mailing address

295 Rivers Edge Dr
Kimberly, WI 54136-4401
Phone (920) 740-2191

Other identifiers 1

IdentifierTypeStateIssuer
35063700MedicaidWI

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
162885-30WIMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1174775506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 RIVERS EDGE DR",
            "city": "KIMBERLY",
            "state": "WI",
            "postal_code": "541364401",
            "telephone_number": "920-740-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1981 GREENGROVE ST",
            "city": "KAUKAUNA",
            "state": "WI",
            "postal_code": "541303921",
            "telephone_number": "920-759-4436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHMAN",
        "first_name": "ANGELA",
        "middle_name": "JEAN",
        "name_suffix": "II",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-16",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "162885-30",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35063700",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kaukauna, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2024; 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.