NPIMap

Individual provider Active NPI

Ashley L Park, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Germantown, TN
National Provider Identifier
1477540169
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
26245 Issued in TN
Practice address
1400 S Germantown Rd
Germantown, TN 38138-2205
Phone
(901) 759-3100
Fax
(901) 759-3196
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 26245 TN Primary

Addresses

Primary practice location

1400 S Germantown Rd
Germantown, TN 38138-2205

Mailing address

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

Other practice location 1

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3100

Other practice location 2

1458 W Poplar Ave Ste 100
Collierville, TN 38017-0630
Phone (901) 759-3100

Other practice location 3

8000 Centerview Pkwy Ste 500
Cordova, TN 38018-4254
Phone (901) 759-3100

Other practice location 4

1211 Union Ave Ste 500
Memphis, TN 38104-6656
Phone (901) 759-3100

Other identifiers 6

IdentifierTypeStateIssuer
Q016952MedicaidTN
100156885MedicaidMS
06629278MedicaidMS
145915001MedicaidAR
100156887MedicaidMS
100156886MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101027001203 TN Practitioner - Physical Medicine and RehabilitationPractitioner - Orthopedic Surgery 0547454142 Reassigns benefits to 1 organization
I20101103000446 MS Practitioner - Physical Medicine and RehabilitationPractitioner - Orthopedic Surgery 0547454142 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Campbell Clinic, PCGroup PAC ID 9638082076, 229 clinicians

Practice addresses (Care Compare)

1400 S Germantown Rd
Germantown, TN 38138-2205
Phone (901) 759-3100

7545 Airways Blvd
Southaven, MS 38671-5806
Phone (901) 759-3196

Hospital & facility affiliations

  • Baptist Memorial Hospital Hospital, Memphis, TN, CCN 440048
  • Baptist Memorial Hospital North Ms Hospital, Oxford, MS, CCN 250034
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Desoto Hospital, Southaven, MS, CCN 250141

Merit-based Incentive Payment System (MIPS)

Final score
75.09 of 100Reported as group
Quality
50.47
Promoting interoperability
99
Improvement activities
40
Cost
67.33

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
26245TNMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Campbell Clinic, PC Physical Medicine & Rehabilitation CurrentSince Jul 20, 1998 Accepting new patients
Campbell Clinic PC CurrentSince Jul 20, 1998 Accepting new patients
Campbell Clinic Past Accepting new patients
CC Bpci PLC Past Accepting new patients

Locations

6760 Goodman Rd
Ste 110
Olive Branch, MS 38654

7545 Airways Blvd
Southaven, MS 38671
Phone (901) 759-3196

11851 Will Harris Dr
Arlington, TN 38002
Phone (901) 430-8263

1458 W Poplar Ave
Ste 100
Collierville, TN 38017
Phone (901) 759-5491

1900 W Poplar Ave
Collierville, TN 38017
Phone (901) 759-5491

1535 Vann Dr
Jackson, TN 38305
Phone (731) 984-9944

1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111

585 S Mendenhall Rd
Memphis, TN 38117

7887 Wolf River Blvd
Memphis, TN 38138
Phone (901) 759-3180

1211 Union Ave
Ste 500
Memphis, TN 38104
Phone (901) 759-3275

Interoperability endpoints

  • Direct secure messaging: ashley.park.1@1366.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/1366/brand/1/csg/1/fhir/r4
  • Direct secure messaging: apark@cco1043.srs-direct.com

Organizations & group practices 26

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.

View all 26

Hospital & facility affiliations 6

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1477540169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "901-759-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 S GERMANTOWN RD",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381382205",
            "telephone_number": "901-759-3100",
            "fax_number": "901-759-3196"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7545 Airways Blvd",
            "address_purpose": "LOCATION",
            "city": "Southaven",
            "state": "MS",
            "postal_code": "386715806",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1458 W Poplar Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Collierville",
            "state": "TN",
            "postal_code": "380170630",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8000 Centerview Pkwy Ste 500",
            "address_purpose": "LOCATION",
            "city": "Cordova",
            "state": "TN",
            "postal_code": "380184254",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1211 Union Ave Ste 500",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381046656",
            "country_code": "US",
            "telephone_number": "901-759-3100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ASHLEY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "26245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q016952",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100156885",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06629278",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "145915001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100156887",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100156886",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.