Individual provider Active NPI

Ashley Francis Heedles

  • Specialist
  • Staten Island, NY
National Provider Identifier
1568136125
Registry record updated Aug 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
1461980211 Issued in NY
Practice address
4024 Amboy Rd
Staten Island, NY 10308-2409
Phone
(718) 984-9022
NPI assigned
Aug 5, 2021
Last updated
Aug 5, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 1461980211 NY Primary

Addresses

Primary practice location

4024 Amboy Rd
Staten Island, NY 10308-2409

Mailing address

20 Bunker Hill Dr
Old Bridge, NJ 08857-3803
Phone (917) 417-8297

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1461980211NYMDSpecialist

NPI Registry JSON

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

{
    "created_epoch": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1568136125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 BUNKER HILL DR",
            "city": "OLD BRIDGE",
            "state": "NJ",
            "postal_code": "088573803",
            "telephone_number": "917-417-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 AMBOY RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103082409",
            "telephone_number": "718-984-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEEDLES",
        "first_name": "ASHLEY",
        "middle_name": "FRANCIS",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NY",
            "license": "1461980211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; 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.