Individual provider Active NPI

Ashley Anne Jenne, PA-C

  • Physician Assistant
  • San Antonio, TX
National Provider Identifier
1255540357
Registry record updated Mar 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04537 Issued in TX
Practice address
4330 Medical Dr
Suite 325
San Antonio, TX 78229-3342
Phone
(210) 615-7700
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2009

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 PA04537 TX Primary

Addresses

Primary practice location

4330 Medical Dr
Suite 325
San Antonio, TX 78229-3342

Mailing address

410 E Mandalay Dr
San Antonio, TX 78212-1744
Phone (210) 824-1266

Other names 1

  • Miss Ashley Anne Woodburn Former name

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Texas Cardiothoracic & Vascular Surgical Associates CurrentSince Feb 18, 2009 Accepting new patients

Locations

4330 Medical Dr
Ste 325
San Antonio, TX 78229
Phone (210) 615-1955

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236816000000",
    "number": "1255540357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 E MANDALAY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782121744",
            "telephone_number": "210-824-1266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4330 MEDICAL DR",
            "address_2": "SUITE 325",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293342",
            "telephone_number": "210-615-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENNE",
        "first_name": "ASHLEY",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2009-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WOODBURN",
            "middle_name": "ANNE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2009; 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.