Individual provider Active NPI

Ashley Packett, MD

  • Pediatric Critical Care Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1376040402
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
2024037096 Issued in MO
Practice address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone
(314) 577-5395
NPI assigned
Apr 5, 2018
Last updated
Oct 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Pediatric Critical Care Medicine Physician 2080P0203X 2024037096 MO Primary

Addresses

Primary practice location

1465 S Grand Blvd
Saint Louis, MO 63104-1003

Mailing address

1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone (314) 577-5395

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250130000418 MO Practitioner - Critical Care (Intensivists) 3072042449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SSM Health Care GroupGroup PAC ID 0143608372, 929 clinicians

Practice addresses (Care Compare)

1201 S Grand Blvd
Saint Louis, MO 63104-1016
Phone (314) 617-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
SSM Health Care Group CurrentSince Jan 1, 2025 Accepting new patients
SSM Health Care Group CurrentSince Jan 1, 2025 Accepting new patients

Locations

10101 Woodfield Ln
Saint Louis, MO 63132
Phone (608) 280-4647

1201 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 257-1320

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

Interoperability endpoints

  • Direct secure messaging: apackett526930@direct-ehr-ssmhc.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1376040402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1465 S GRAND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631041003",
            "telephone_number": "314-577-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACKETT",
        "first_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MO",
            "license": "2024037096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.