Ashley Nicole Gassaway, OTR/L

Individual provider Active NPI Specialist · Joplin, MO

NPI 1295043719 · NPPES record last updated Sep 17, 2010

Key facts

NPI
1295043719
Entity type
Individual (NPI type 1)
Primary specialty
Specialist 174400000X
License
2010028133 (MO)
Practice address
1101 Goetz Blvd
Joplin, MO 64801-1431
Phone
(417) 629-3044
NPI assigned
Sep 17, 2010
Sex
Female
Sole proprietor
No

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
2010028133MOMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Access Potential Therapy Services, LLC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 2010028133 MO Yes

Addresses

Primary practice location

1101 Goetz Blvd
Joplin, MO 64801-1431

Mailing address

1983 S Farm Road 69
Republic, MO 65738-2690
Phone (417) 619-1424

Other providers in Joplin, MO

All providers in Joplin, MO · Specialist in Missouri

Sources for this page

Verify at the official NPI Registry.