Individual provider Active NPI

Ashley Attaway, AGPCNP

  • Adult Health Nurse Practitioner
  • Mansfield, TX
National Provider Identifier
1487353876
Registry record updated Apr 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
1056945 Issued in TX
Practice address
1601 E Debbie LN
Mansfield, TX 76063-3674
Phone
(817) 473-9125
Fax
(817) 473-9126
NPI assigned
Feb 24, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 1056945 TX Primary

Addresses

Primary practice location

1601 E Debbie LN
Mansfield, TX 76063-3674

Mailing address

1601 E Debbie LN
Mansfield, TX 76063-3674
Phone (817) 473-9125

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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240425004141 TX Practitioner - Nurse Practitioner 6709226665 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1056945TXMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince May 6, 2024 Accepting new patients
Medhealth CurrentSince May 6, 2024 Accepting new patients
Methodist Transplant Physicians Past Accepting new patients

Locations

221 W Colorado Blvd
Ste 438
Dallas, TX 75208

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

2700 E Broad St
Mansfield, TX 76063
Phone (682) 242-2000

1601 E Debbie Ln
Ste 2109
Mansfield, TX 76063
Phone (817) 453-8620

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": "1677196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714435200000",
    "number": "1487353876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 E DEBBIE LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633674",
            "telephone_number": "817-473-9125",
            "fax_number": "817-473-9126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 E DEBBIE LN",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633674",
            "telephone_number": "817-473-9125",
            "fax_number": "817-473-9126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATTAWAY",
        "first_name": "ASHLEY",
        "credential": "AGPCNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-02-24",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1056945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.