Ashley Laine Anderson, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0000012721 Issued in TN

Practice address

228 Park Ave S
Ste 16389
New York, NY 10003-1502

Phone

(646) 876-8455

Fax

(833) 314-0246

NPI assigned

Apr 18, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ashley.anderson.1@22307.direct.athenahealth.com

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.

• Octennial Health Services, LLC

  • Family Nurse Practitioner
  • Johnson City, TN
  • NPI 1649098005
  Medicare reassignment NPD Authorized official
• Tri-Cities Gastroenterology LLC

  • Gastroenterology Physician
  • Kingsport, TN
  • NPI 1083639918
  Medicare reassignment NPD

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1487870077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 PARK AVE S STE 16389",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031502",
            "telephone_number": "646-876-8455",
            "fax_number": "833-314-0246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "228 PARK AVE S",
            "address_2": "STE 16389",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100031502",
            "telephone_number": "646-876-8455",
            "fax_number": "833-314-0246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ASHLEY",
        "middle_name": "LAINE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "149538",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "0000012721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Theodora Anderson, D.D.S.,M.S.
• Angelique Anderson, M.D.
• Anna-Olivia Anderson
• Ariel M Anderson, MD
• Ashley Anderson, LMSW, CASAC
• Belinda Jane Anderson, PHD. LAC
• Bradley John Anderson, MD, MS
• Brett Anderson, M.D.
• Brittany Monique Anderson, LCSW
• Camrin Strickler Anderson, RN, FNP-C

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.