Individual provider Active NPI

Ashley Brooke Gavin, NP

  • Gerontology Nurse Practitioner
  • Byron Center, MI
National Provider Identifier
1295373736
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
4704290290 Issued in MI
Practice address
7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001
Phone
(616) 267-7668
NPI assigned
Dec 16, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 4704290290 MI Primary

Addresses

Primary practice location

7751 Byron Center Ave SW Ste C
Byron Center, MI 49315-8001

Mailing address

100 Michigan St NE # Mc845
Grand Rapids, MI 49503-2560

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address agavin172170@epic00.shdirect.org
FHIR URL https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200113001851 MI Practitioner - Nurse Practitioner 2668807066 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reed City Hospital CorporationGroup PAC ID 6406740695, 32 clinicians

Practice addresses (Care Compare)

300 N Patterson Rd
Corewell Health Reed City Hospital
Reed City, MI 49677-8041
Phone (231) 832-7170

4499 220TH Ave
Reed City, MI 49677-8593
Phone (231) 832-5817

Hospital & facility affiliations

  • Spectrum Health Hospital, Grand Rapids, MI, CCN 230038
  • Corewell Health Reed City Hospital Hospital, Reed City, MI, CCN 231323
  • Spectrum Health United Hospital Hospital, Greenville, MI, CCN 230035

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704290290MIMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Reed City Hospital Corporation CurrentSince Jan 19, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 19, 2020 Accepting new patients
Spectrum Health Primary Care Partners CurrentSince Jan 19, 2020 Accepting new patients
Spectrum Health United CurrentSince Jan 19, 2020 Accepting new patients
Reed City Hospital Corporation Current Accepting new patients
Reed City Hospital Corporation CurrentSince Jan 19, 2020 Accepting new patients
Spectrum Health United CurrentSince Jan 19, 2020 Accepting new patients

Locations

1227 W State St
Belding, MI 48809
Phone (616) 794-0800

7751 Byron Center Ave SW
Ste C
Byron Center, MI 49315
Phone (616) 267-7668

100 Michigan St NE
#845
Grand Rapids, MI 49503
Phone (616) 391-8242

1202 W Oak St
Greenville, MI 48838
Phone (616) 754-2944

1725 Port Sheldon St
Jenison, MI 49428
Phone (616) 667-1725

4444 Kalamazoo Ave SE
Ste 200
Kentwood, MI 49508
Phone (616) 391-5600

418 Washington St
Lakeview, MI 48850
Phone (989) 352-6474

300 N Patterson Rd
Reed City, MI 49677
Phone (231) 832-3271

Interoperability endpoints

  • Direct secure messaging: agavin172170@epic00.shdirect.org
  • Direct secure messaging: agavin172170@epic00.corewelldirect.org

Organizations & group practices 7

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 4

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": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1295373736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7751 BYRON CENTER AVE SW STE C",
            "city": "BYRON CENTER",
            "state": "MI",
            "postal_code": "493158001",
            "telephone_number": "616-267-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVIN",
        "first_name": "ASHLEY",
        "middle_name": "BROOKE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MI",
            "license": "4704290290",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "agavin172170@epic00.shdirect.org",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicarr02.spectrumhealth.org/EpicFHIR/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "7751 Byron Center Ave SW Ste C",
            "city": "Byron Center",
            "state": "MI",
            "country_code": "US",
            "postal_code": "493158001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Byron Center, MI

Sources for this page

Verify at the official NPI Registry.