Individual provider Active NPI

Ashley Vanderdasson, FNP, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Burns, OR
National Provider Identifier
1225300395
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
201150183NP Issued in OR
Practice address
348 W Adams St
Burns, OR 97720-1710
Phone
(541) 573-8376
Fax
(541) 573-8378
NPI assigned
Feb 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 201150183NP OR
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 201150183NP OR Primary

Addresses

Primary practice location

348 W Adams St
Burns, OR 97720-1710

Mailing address

348 W Adams St
Burns, OR 97720-1710
Phone (541) 573-8376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20170109002556 OR Practitioner - Nurse Practitioner 1456584820 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

348 W Adams St
Burns, OR 97720-1710
Phone (541) 573-8376

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
201150183NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Symmetry Care, Inc. CurrentSince Jan 9, 2017 Accepting new patients
Symmetry Care, Inc. CurrentSince Jan 9, 2017 Accepting new patients

Locations

348 W Adams St
Burns, OR 97720
Phone (541) 573-8376

Organizations & group practices 2

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 2

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": "1328227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674432000000",
    "number": "1225300395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376",
            "fax_number": "541-573-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 W ADAMS ST",
            "city": "BURNS",
            "state": "OR",
            "postal_code": "977201710",
            "telephone_number": "541-573-8376",
            "fax_number": "541-573-8378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERDASSON",
        "first_name": "ASHLEY",
        "name_prefix": "Miss",
        "credential": "FNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-03",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "201150183NP",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "201150183NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burns, OR

Sources for this page

Verify at the official NPI Registry.