Individual provider Active NPI

Ashawnda S Pigram

  • Driver
  • Maywood, IL
National Provider Identifier
1306311147
Registry record updated Oct 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DriverTaxonomy code 172A00000X
License
E907224 Issued in IL
Practice address
2107 S 8TH Ave
Maywood, IL 60153-3230
Phone
(708) 838-4654
NPI assigned
Oct 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DriverGroup: 193200000X MULTI-SPECIALTY GROUP 172A00000X E907224 IL Primary

Addresses

Primary practice location

2107 S 8TH Ave
Maywood, IL 60153-3230

Mailing address

2107 S 8TH Ave
Maywood, IL 60153-3230

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
E907224ILMDDriver

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538956800000",
    "number": "1306311147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2107 S 8TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2107 S 8TH AVE",
            "city": "MAYWOOD",
            "state": "IL",
            "postal_code": "601533230",
            "telephone_number": "708-838-4654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIGRAM",
        "first_name": "ASHAWNDA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-08",
        "last_updated": "2018-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Driver",
            "state": "IL",
            "license": "E907224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maywood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.