Individual provider Active NPI

Ashley Davis, FNP

  • Dermatology Physician
  • Winston Salem, NC
National Provider Identifier
1306460811
Registry record updated Jun 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
400362 Issued in NC
Practice address
765 Highland Oaks Dr Ste 100
Winston Salem, NC 27103-7100
Phone
(336) 760-4004
Fax
(336) 760-6632
NPI assigned
Jun 1, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 400362 NC
Dermatology Physician 207N00000X 400362 NC Primary

Addresses

Primary practice location

765 Highland Oaks Dr Ste 100
Winston Salem, NC 27103-7100

Mailing address

528 White Dirt Rd
Dobson, NC 27017-7646
Phone (336) 366-7611

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200914000452 NC Practitioner - Nurse Practitioner 3971921610 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
400362NCMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Regional Healthcare Group LLC CurrentSince Sep 10, 2024 Accepting new patients
Guardian Biologics LLC Specialist CurrentSince Oct 18, 2024 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590969600000",
    "number": "1306460811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 WHITE DIRT RD",
            "city": "DOBSON",
            "state": "NC",
            "postal_code": "270177646",
            "telephone_number": "336-366-7611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 HIGHLAND OAKS DR STE 100",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271037100",
            "telephone_number": "336-760-4004",
            "fax_number": "336-760-6632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ASHLEY",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2020-06-01",
        "certification_date": "2020-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NC",
            "license": "400362",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "400362",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.