Individual provider Active NPI

Ashlee Nacole Spann

  • Dentist
  • Amarillo, TX
National Provider Identifier
1457046120
Registry record updated Jul 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40765 Issued in TX
Practice address
3113 Ross St
Amarillo, TX 79103-2700
Phone
(806) 374-7341
NPI assigned
Apr 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40765 TX Primary

Addresses

Primary practice location

3113 Ross St
Amarillo, TX 79103-2700

Mailing address

1905 Margaret Dr
Wichita Falls, TX 76306-1819
Phone (940) 257-5784

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240801000199 TX Practitioner - Dentist 8224575865 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Regence Health Network Inc Current Accepting new patients
Regence Health Network Inc CurrentSince Aug 1, 2024 Accepting new patients
Regence Health Network Inc CurrentSince Aug 1, 2024 Accepting new patients

Locations

3113 Ross St
Amarillo, TX 79103
Phone (806) 374-7341

410 Canyon St
Plainview, TX 79072
Phone (806) 291-0297

Organizations & group practices 3

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": "1681084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1457046120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1905 MARGARET DR",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763061819",
            "telephone_number": "940-257-5784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 ROSS ST",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "791032700",
            "telephone_number": "806-374-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPANN",
        "first_name": "ASHLEE",
        "middle_name": "NACOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-10",
        "last_updated": "2024-07-22",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "40765",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amarillo, TX

Sources for this page

Verify at the official NPI Registry.