Individual provider Active NPI

Ashley Brooke Deaton, APRN, FNP-C

  • Family Nurse Practitioner
  • South Pasadena, FL
National Provider Identifier
1508418740
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
11003073 Issued in FL
Practice address
1501 Pasadena Ave S
South Pasadena, FL 33707-3717
Phone
(252) 671-1108
NPI assigned
Jul 9, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 11003073 FL Primary

Addresses

Primary practice location

1501 Pasadena Ave S
South Pasadena, FL 33707-3717

Mailing address

801 W Bay Dr Ste 605
Largo, FL 33770-3268
Phone (252) 671-1108

Other practice location 1

701 6th St S
Saint Petersburg, FL 33701-4814
Phone (727) 823-1234

Other practice location 2

1200 7th Ave N
Saint Petersburg, FL 33705-1300
Phone (727) 825-1100

Other practice location 3

201 14th St SW
Largo, FL 33770-3133
Phone (252) 671-1108

Other names 1

  • Ashley Brooke Moore Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20210113001366 FL Practitioner - Nurse Practitioner 7810300746 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Value Based Long Term Care F PCGroup PAC ID 2769922731, 18 clinicians
Legacy Health Medical Group, LLCGroup PAC ID 5193962173, 17 clinicians

Practice addresses (Care Compare)

801 W Bay Dr
Suite 605
Largo, FL 33770-3268
Phone (727) 489-3305

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11003073FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Value Based Long Term Care F PC CurrentSince Jul 1, 2025 Accepting new patients
Orlando Health, Inc. Current Accepting new patients

Locations

5 Research Dr
Shelton, CT 06484
Phone (203) 567-5264

801 West Bay Dr
Ste 605
Largo, FL 33770
Phone (727) 489-3305

Interoperability endpoints

  • Direct secure messaging: amoore188932@orlandohealth.medalliesdirect.net

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": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1508418740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 W BAY DR STE 605",
            "city": "LARGO",
            "state": "FL",
            "postal_code": "337703268",
            "telephone_number": "252-671-1108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 PASADENA AVE S",
            "city": "SOUTH PASADENA",
            "state": "FL",
            "postal_code": "337073717",
            "telephone_number": "252-671-1108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 6th St S",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337014814",
            "country_code": "US",
            "telephone_number": "727-823-1234",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 7th Ave N",
            "address_purpose": "LOCATION",
            "city": "Saint Petersburg",
            "state": "FL",
            "postal_code": "337051300",
            "country_code": "US",
            "telephone_number": "727-825-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "201 14th St SW",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337703133",
            "country_code": "US",
            "telephone_number": "252-671-1108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEATON",
        "first_name": "ASHLEY",
        "middle_name": "BROOKE",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11003073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MOORE",
            "middle_name": "BROOKE",
            "credential": "APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in South Pasadena, FL

Sources for this page

Verify at the official NPI Registry.