Ashley Renee Noeth, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

209014724 Issued in IL

Practice address

4955 S State Route 159
Suite 1
Glen Carbon, IL 62034-1907

Phone

(618) 288-7855

Fax

(618) 288-7866

NPI assigned

Sep 30, 2016

Last updated

Aug 29, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1475193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1548719651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4955 S STATE ROUTE 159 STE 1",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341907",
            "telephone_number": "618-288-7855",
            "fax_number": "618-288-7866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4955 S STATE ROUTE 159",
            "address_2": "SUITE 1",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341907",
            "telephone_number": "618-288-7855",
            "fax_number": "618-288-7866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOETH",
        "first_name": "ASHLEY",
        "middle_name": "RENEE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-30",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IL",
            "license": "209014724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Family Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.