NPIMap

Organization Active NPI

Ashe Multispecialty Group, LLC

Doing business as Ashe Women & Children's Health

  • Family Medicine Physician
  • Jefferson, NC
National Provider Identifier
1255054623
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ASHE MULTISPECIALTY GROUP, LLC
Doing business as
Ashe Women & Children's Health
Practice address
200 Hospital Ave
Jefferson, NC 28640-9244
Phone
(336) 846-7101
NPI assigned
Sep 21, 2022
Last updated
Apr 18, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2023

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

Authorized official

Name
Richard Paul Brodeur
Title
Director of Practice Management
Phone
(336) 846-0821

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

200 Hospital Ave
Jefferson, NC 28640-9244

Mailing address

200 Hospital Ave
Jefferson, NC 28640-9244
Phone (336) 846-7101

Other names 1

  • Ashe Women & Children's Health Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110712000000 NC Part B Supplier - Clinic/Group Practice 8022296318 Receives reassigned benefits from 12 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jefferson, NC

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
34D2277466Ashe Women & Children's Health200 Hospital Avenue, Jefferson, NC 28640Provider-performed microscopyFeb 27, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ashe Multispecialty Group LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1255054623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL AVE",
            "city": "JEFFERSON",
            "state": "NC",
            "postal_code": "286409244",
            "telephone_number": "336-846-7101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASHE MULTISPECIALTY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-21",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "BRODEUR",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR OF PRACTICE MANAGEMENT",
        "authorized_official_telephone_number": "336-846-0821"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ashe Women & Children's Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ashe Women & Children's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jefferson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.