Individual provider Active NPI

Ashley Fender, APRN

  • Nurse Practitioner
  • Orange City, FL
National Provider Identifier
1437874120
Registry record updated Dec 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
11022190 Issued in FL
Practice address
2555 S Volusia Ave
Orange City, FL 32763-9116
Phone
(386) 774-0401
NPI assigned
Oct 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 21, 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 11022190 FL Primary

Addresses

Primary practice location

2555 S Volusia Ave
Orange City, FL 32763-9116

Mailing address

2105 S Park Ave
Sanford, FL 32771-4349
Phone (407) 878-0181

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20251006004036 FL Practitioner - Nurse Practitioner 6406353648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

317 6TH Ave
Suite 400
Des Moines, IA 50309-4037

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11022190FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Care Medical Group, LLC CurrentSince Dec 24, 2023 Accepting new patients
Magnus Medical Center Inc CurrentSince Dec 24, 2023 Accepting new patients
Central Florida Medical Associates, Inc CurrentSince Feb 8, 2023 Accepting new patients
Openloop Healthcare Partners PC Nurse Practitioner CurrentSince Aug 1, 2025 Accepting new patients

Locations

3707 E Southern Ave
#1
Mesa, AZ 85206
Phone (424) 387-6806

2105 S Park Ave
Sanford, FL 32771
Phone (407) 330-9082

8270 Woodland Center Blvd
Tampa, FL 33614
Phone (305) 449-9219

317 6th Ave
Ste 400
Des Moines, IA 50309
Phone (515) 612-9097

500 Marquette Ave NW
Albuquerque, NM 87102
Phone (505) 429-5750

1240 Winnowing Way
Unit 102
Mt Pleasant, SC 29466
Phone (828) 396-5634

4500 Mercantile Plaza Dr
Fort Worth, TX 76137
Phone (214) 635-6412

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1437874120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 S PARK AVE",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327714349",
            "telephone_number": "407-878-0181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2555 S VOLUSIA AVE",
            "city": "ORANGE CITY",
            "state": "FL",
            "postal_code": "327639116",
            "telephone_number": "386-774-0401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENDER",
        "first_name": "ASHLEY",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11022190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, FL

Sources for this page

Verify at the official NPI Registry.