Individual provider Active NPI

Ashley Mo, MD

  • Pediatrics Physician
  • Henderson, NV
National Provider Identifier
1417375049
Registry record updated Aug 6, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
17225 Issued in NV
Practice address
2350 W Horizon Ridge Pkwy
Henderson, NV 89052
Phone
(702) 564-8556
Fax
(702) 564-4485
NPI assigned
Apr 1, 2014
Last updated
Aug 6, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 17225 NV Primary

Addresses

Primary practice location

2350 W Horizon Ridge Pkwy
Henderson, NV 89052

Mailing address

2350 W Horizon Ridge Pkwy
Henderson, NV 89052-5075
Phone (702) 564-8556

Other identifiers 1

IdentifierTypeStateIssuer
1417375049MedicaidNV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
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
I20160114000610 NV Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 6406159094

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
17225NVMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Valley Medical Center Past Accepting new patients
Southern Hills Medical Center, LLC Past Accepting new patients
Misch/Hyun/Hodapp Healthcare, LLP Pediatrics PastSince Aug 11, 2019 Accepting new patients
Dignity Health Past Accepting new patients

Organizations & group practices 4

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": "1396310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565049600000",
    "number": "1417375049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890525075",
            "telephone_number": "702-564-8556",
            "fax_number": "702-564-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 W HORIZON RIDGE PKWY",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89052",
            "telephone_number": "702-564-8556",
            "fax_number": "702-564-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MO",
        "first_name": "ASHLEY",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-04-01",
        "last_updated": "2019-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NV",
            "license": "17225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1417375049",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.