Individual provider Active NPI

Ashley Quinn Nutt I

  • Psychiatric/Mental Health Nurse Practitioner
  • Livonia, MI
National Provider Identifier
1295557254
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704344422 Issued in MI
Practice address
29502 Bobrich St
Livonia, MI 48152-3496
Phone
(734) 776-9263
NPI assigned
Oct 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 4704344422 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704344422 MI Primary

Addresses

Primary practice location

29502 Bobrich St
Livonia, MI 48152-3496

Mailing address

29502 Bobrich St
Livonia, MI 48152-3496
Phone (734) 776-9263

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
I20250109000166 MI Practitioner - Nurse Practitioner 3476081191 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Wayne State University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Apex Therapy Services IncGroup PAC ID 1951526029, 4 clinicians

Practice addresses (Care Compare)

30200 Telegraph Rd
Suite 207
Bingham Farms, MI 48025-5711
Phone (248) 712-1129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704344422MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Therapy Services, Inc CurrentSince Dec 21, 2024 Accepting new patients

Locations

30200 Telegraph Rd
Ste 207
Bingham Farms, MI 48025
Phone (218) 712-1129

2674 W Jefferson Ave
Ste 206
Trenton, MI 48183

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": "1730246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1295557254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29502 BOBRICH ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523496",
            "telephone_number": "734-776-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29502 BOBRICH ST",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481523496",
            "telephone_number": "734-776-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUTT",
        "first_name": "ASHLEY",
        "middle_name": "QUINN",
        "name_suffix": "I",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-30",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704344422",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704344422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.