Ashley Fatheree

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

10482 Issued in MN

Practice address

11850 Blackfoot St NW Ste 100
Coon Rapids, MN 55433-2774

Phone

(763) 712-2100

Fax

(763) 712-2190

NPI assigned

Jun 21, 2021

Last updated

Aug 9, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MN2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Minnesota Oncology Hematology PAGroup PAC ID 6709799752, 131 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashley.fatheree@moh.ikm.direct-ci.com

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.

• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1528035995

  Gynecologic Oncology

  Medicare reassignment Care Compare group NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581
  Medicare reassignment NPD
• Minnesota Oncology Hematology PA

  • Hematology & Oncology Physician
  • Chaska, MN
  • NPI 1598178733

  Gynecologic Oncology

  NPD
• Minnesota Oncology Hematology PA

  dba MN Cancer Care Pharmacy

  • Community/Retail Pharmacy
  • Maple Grove, MN
  • NPI 1811601123
  NPD
• Minnesota Oncology Hematology, PA

  • Radiation Oncology Physician
  • Saint Paul, MN
  • NPI 1598305427
  NPD (past)
• Minnesota Oncology Hematology, PA

  • Hematology & Oncology Physician
  • Saint Paul, MN
  • NPI 1609911205

  Gynecologic Oncology

  NPD (past)

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

{
    "created_epoch": "1624233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691539200000",
    "number": "1467021816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332774",
            "telephone_number": "763-712-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11850 BLACKFOOT ST NW STE 100",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554332774",
            "telephone_number": "763-712-2100",
            "fax_number": "763-712-2190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8081 Innovation Park Dr",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220314867",
            "country_code": "US",
            "telephone_number": "571-472-4724",
            "fax_number": "571-472-0241",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2150 Pennsylvania Ave NW Fl 5",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200373201",
            "country_code": "US",
            "telephone_number": "202-741-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FATHEREE",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-21",
        "last_updated": "2023-08-09",
        "certification_date": "2023-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "VA",
            "license": "0024186462",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "10482",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "DC",
            "license": "RN1051347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Autumn E. S. R. Fancher, LPCC
• Deka Farah
• Daniel McGeary Farber, MD
• Daniel John Farnham, CRNA
• Oladepo Collins Fasoranti, MBBS
• Jessica Chiyoko Fedor, O.D.
• Andrew Feld, PHARM.D.
• Carly Felicetta
• Kayla Margaret Felix, MHP, MS
• Stephanie Lane Fennessey, MS, RD, LD, CDE

• Nurse Practitioner in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.