Individual provider Active NPI

Ashley Nicole Gwyn

  • Physician Assistant
  • Winston Salem, NC
National Provider Identifier
1518568013
Registry record updated Feb 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone
(336) 251-1114
Fax
(336) 251-1117
NPI assigned
Nov 3, 2020
Last updated
Feb 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

4692 Brownsboro Rd
Winston Salem, NC 27106-3410

Mailing address

4692 Brownsboro Rd
Winston Salem, NC 27106-3410
Phone (336) 251-1114

Other practice location 1

2021 Frank Rd
Asheboro, NC 27205-1381
Phone (336) 301-2807

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20210316000100 NC Practitioner - Physician Assistant 6103232269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

260 Hospital Dr
Brevard, NC 28712-3378
Phone (828) 213-6115

288 S Ridgecrest Ave
Rutherfordton, NC 28139-2838
Phone (828) 286-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1604361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1518568013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063410",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1117"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2021 Frank Rd",
            "address_purpose": "LOCATION",
            "city": "Asheboro",
            "state": "NC",
            "postal_code": "272051381",
            "country_code": "US",
            "telephone_number": "336-301-2807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GWYN",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-03",
        "last_updated": "2021-02-09",
        "certification_date": "2021-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.