Active NPI
Ashley Nicole Dougvillo
- Physical Therapist
- Mount Pleasant, WI
National Provider Identifier
1306143268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11656-24
- Practice address
- 13250 Washington Ave
Mount Pleasant, WI 53177-1516 - Phone
- (262) 799-8330
- NPI assigned
- Feb 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11656-24 | WI | Primary |
| Physical Therapist | 225100000X | 070-018760 | IL |
Addresses
Primary practice location
13250 Washington Ave
Mount Pleasant, WI 53177-1516
Mailing address
3049 Momentum PL
Chicago, IL 60689-1957
Phone (262) 657-0222
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P01163847 | Other | WI | RAILROAD MEDICARE |
| 859400061 | Other | WI | MEDICARE |
| IL6238017 | Other | IL | MEDICARE |
| IL6237017 | Other | IL | MEDICARE |
Other names 1
- Ashley Flament
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070-018760 | IL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1297382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1728345600000",
"number": "1306143268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3049 MOMENTUM PL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606891957",
"telephone_number": "262-657-0222",
"fax_number": "262-657-7190"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13250 WASHINGTON AVE",
"city": "MOUNT PLEASANT",
"state": "WI",
"postal_code": "531771516",
"telephone_number": "262-799-8330"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGVILLO",
"first_name": "ASHLEY",
"middle_name": "NICOLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-02-11",
"last_updated": "2024-10-08",
"certification_date": "2024-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "11656-24",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-018760",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01163847",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "859400061",
"state": "WI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "IL6238017",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "IL6237017",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ASHLEY",
"last_name": "FLAMENT",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Mount Pleasant, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.