Ashley Ivey Anderson, PTA

Individual provider Active NPI Physical Therapy Assistant · Beulaville, NC

NPI 1306104104 · NPPES record last updated Apr 30, 2012

Key facts

NPI
1306104104
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapy Assistant 225200000X
License
4597 (NC)
Practice address
159 Crossover Rd
Beulaville, NC 28518-8801
Phone
(910) 298-6455
NPI assigned
Apr 30, 2012
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

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
4597NCMDPediatric Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards and Associates Physical Therapy Past
since Feb 14, 2021
Accepting new patients
Carolina Rehabilitation Inc Past
since Aug 16, 2009
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 4597 NC Yes

Addresses

Primary practice location

159 Crossover Rd
Beulaville, NC 28518-8801

Mailing address

159 Crossover Rd
Beulaville, NC 28518-8801
Phone (910) 298-6455

Other providers in Beulaville, NC

All providers in Beulaville, NC · Physical Therapy Assistant in North Carolina

Sources for this page

Verify at the official NPI Registry.