Active NPI
Ashton Kannenberg, PA-C
- Physician Assistant
- Georgetown, TX
National Provider Identifier
1356740856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA09337
- Practice address
- 4945 Williams Dr
Georgetown, TX 78633-2008 - Phone
- (512) 819-0500
- NPI assigned
- Aug 20, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA09337 | TX | Primary |
Addresses
Primary practice location
4945 Williams Dr
Georgetown, TX 78633-2008
Mailing address
PO Box 844658
Dallas, TX 75284-4658
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | aschutza63851@direct.sw.org |
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
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1408492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643068800000",
"number": "1356740856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 844658",
"city": "DALLAS",
"state": "TX",
"postal_code": "752844658"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4945 WILLIAMS DR",
"city": "GEORGETOWN",
"state": "TX",
"postal_code": "786332008",
"telephone_number": "512-819-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KANNENBERG",
"first_name": "ASHTON",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-20",
"last_updated": "2022-01-25",
"certification_date": "2022-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA09337",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "aschutza63851@direct.sw.org",
"affiliation": "N",
"address_1": "4945 Williams Dr",
"city": "Georgetown",
"state": "TX",
"country_code": "US",
"postal_code": "786332008",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Georgetown, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.