Individual provider Active NPI

Ashley Champlin

  • Nurse Practitioner
  • Albuquerque, NM
National Provider Identifier
1407449838
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
56369 Issued in NM
Practice address
1100 Central Ave SE
Albuquerque, NM 87106-4934
Phone
(505) 841-1234
NPI assigned
Feb 17, 2021
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 56369 NM Primary

Addresses

Primary practice location

1100 Central Ave SE
Albuquerque, NM 87106-4934

Mailing address

6 Anasazi Trails Loop
Placitas, NM 87043-8760
Phone (330) 421-8013

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20210319001263 NM Practitioner - Nurse Practitioner 3779990668 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Cincinnati College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Presbyterian Healthcare ServicesGroup PAC ID 9234041708, 1,390 clinicians

Practice addresses (Care Compare)

201 Cedar St SE
Suite 7600
Albuquerque, NM 87106-4921
Phone (505) 563-2500

2200 W 21St St
Clovis, NM 88101-2011
Phone (505) 769-7577

7920 Carmel Ave NE
Albuquerque, NM 87122-2966
Phone (505) 828-4789

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.68 of 100Reported as group
Quality
82.35
Promoting interoperability
100
Improvement activities
40
Cost
76.6

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56369NMMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Presbyterian Healthcare Services CurrentSince Jan 3, 2023 Accepting new patients
Presbyterian Healthcare Services CurrentSince Jan 3, 2023 Accepting new patients
Vessel Health LLC CurrentSince Mar 1, 2021 Accepting new patients
Presbyterian Healthcare Services Past Accepting new patients
Aaron K. Clark MD PC PastSince Feb 1, 2021 Accepting new patients

Locations

10601 4th St NW
Albuquerque, NM 87114
Phone (505) 828-3000

1100 Central Ave SE
Albuquerque, NM 87106
Phone (505) 724-6124

201 Cedar St SE
Ste 7600
Albuquerque, NM 87106
Phone (505) 563-2500

7920 Carmel Ave NE
Albuquerque, NM 87122
Phone (505) 828-4789

2200 W 21st St
Clovis, NM 88101
Phone (505) 769-7577

2400 Unser Blvd SE
Ste 18300
Rio Rancho, NM 87124
Phone (505) 253-6300

Interoperability endpoints

  • Direct secure messaging: aminck222917@direct.phs.org
  • FHIR API: https://api.platform.athenahealth.com/11879/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1613520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1407449838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 ANASAZI TRAILS LOOP",
            "city": "PLACITAS",
            "state": "NM",
            "postal_code": "870438760",
            "telephone_number": "330-421-8013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 CENTRAL AVE SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064934",
            "telephone_number": "505-841-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAMPLIN",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-17",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "56369",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

Verify at the official NPI Registry.