Ashley Taylor Nickerson, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7795 Issued in AZ

Practice address

2400 S Avenue a
Yuma, AZ 85364-7127

Phone

(928) 336-7505

NPI assigned

Mar 17, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Arizona Em-I Medical Services PC

  • Physician Assistant
  • Yuma, AZ
  • NPI 1144768862
  Medicare reassignment NPD

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

{
    "created_epoch": "1584403200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584403200000",
    "number": "1336775766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3676 S PLOWMAN DR",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853656726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 S AVENUE A",
            "city": "YUMA",
            "state": "AZ",
            "postal_code": "853647127",
            "telephone_number": "928-336-7505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NICKERSON",
        "first_name": "ASHLEY",
        "middle_name": "TAYLOR",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-17",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Khang Nguyen, PA
• Leyah Nguyen, PHARMD
• Nhut Nguyen, MD
• Sang M Nguyen
• Julian J. Nicholas, M.D.
• Lisa Nickle
• Alissa J Nieves
• Krishna Nimmagadda
• Stephen Njoroge, MD
• Kathleen Noble

• Physician Assistant in Yuma, AZ
• Providers in Yuma, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.