NPIMap

Individual provider Active NPI

Ashley Lynn Taylor Thorn, PA-C

  • Physician Assistant
  • Greeley, CO
National Provider Identifier
1255802393
Registry record updated Jan 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0005649 Issued in CO
Practice address
1801 16TH St
Greeley, CO 80631-5154
Phone
(970) 810-3894
NPI assigned
Dec 16, 2018
Last updated
Jan 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2023

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 PA.0005649 CO Primary

Addresses

Primary practice location

1801 16TH St
Greeley, CO 80631-5154

Mailing address

2114 Honeybee Dr
Windsor, CO 80550-3435
Phone (520) 906-6872

Other names 1

  • Ashley Lynn Gross Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190124002914 CO Practitioner - Physician Assistant 7517204852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1801 16TH St
Greeley, CO 80631-5154
Phone (970) 810-4121

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0005649COMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Banner Health Physicians Colorado LLC CurrentSince Mar 1, 2019 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Feb 21, 2022 Accepting new patients
Banner Health Physicians Colorado LLC CurrentSince Mar 1, 2019 Accepting new patients
Banner Hospital Based Physicians Colorado LLC CurrentSince Feb 21, 2022 Accepting new patients
NCMC Specialty Clinic CurrentSince Dec 24, 2020 Accepting new patients
Banner Health Physicians Colorado LLC Past Accepting new patients

Locations

4700 Lady Moon Dr
Ste C1
Fort Collins, CO 80528
Phone (970) 821-4500

1800 15th St
Ste 200
Greeley, CO 80631
Phone (970) 348-0020

1801 16th St
Greeley, CO 80631
Phone (970) 352-4121

1801 16th St
Ste C2B
Greeley, CO 80631
Phone (970) 810-4121

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674864000000",
    "number": "1255802393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2114 HONEYBEE DR",
            "city": "WINDSOR",
            "state": "CO",
            "postal_code": "805503435",
            "telephone_number": "520-906-6872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 16TH ST",
            "city": "GREELEY",
            "state": "CO",
            "postal_code": "806315154",
            "telephone_number": "970-810-3894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR THORN",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-16",
        "last_updated": "2023-01-28",
        "certification_date": "2023-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0005649",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "GROSS",
            "middle_name": "LYNN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greeley, CO

Sources for this page

Verify at the official NPI Registry.