Individual provider Active NPI

Ashley Nicole Gonzales, FNP-C

  • Nurse Practitioner
  • Odessa, TX
National Provider Identifier
1285250183
Registry record updated Apr 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
F06201247 Issued in TX
Practice address
2487 E 11TH St
Odessa, TX 79761-4232
Phone
(432) 332-1386
NPI assigned
Jun 17, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X F06201247 TX Primary

Addresses

Primary practice location

2487 E 11TH St
Odessa, TX 79761-4232

Mailing address

2487 E 11TH St
Odessa, TX 79761-4232
Phone (432) 332-1386

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Midland

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20210129001802 TX Practitioner - Nurse Practitioner 9739593948 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Scotty Ortega MD LLPGroup PAC ID 2567742943, 12 clinicians

Practice addresses (Care Compare)

1701 N Loop 250
Midland, TX 79707-6002
Phone (432) 522-5033

3001 N Faudree Rd
Odessa, TX 79765-8875
Phone (432) 332-1386

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F06201247TXMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Scotty Ortega MD LLP Nurse Practitioner CurrentSince Dec 8, 2020 Accepting new patients

Locations

1701 N Loop 250 W
Midland, TX 79707
Phone (432) 522-5033

980 E 87th St
Ste D
Odessa, TX 79765
Phone (432) 366-0770

2487 E 11th St
Odessa, TX 79761
Phone (432) 332-1386

3001 N Faudree Rd
Odessa, TX 79765
Phone (432) 332-1386

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.

Hospital & facility affiliations 3

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": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618272000000",
    "number": "1285250183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2487 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614232",
            "telephone_number": "432-332-1386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2487 E 11TH ST",
            "city": "ODESSA",
            "state": "TX",
            "postal_code": "797614232",
            "telephone_number": "432-332-1386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GONZALES",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2021-04-13",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "F06201247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Midland",
            "affiliation": "N",
            "address_1": "2200 W Wadley Ave Ste 10",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797056405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Odessa, TX

Sources for this page

Verify at the official NPI Registry.