Organization Active NPI

Nathan Ashby DPM PLLC

  • Podiatrist
  • Fayetteville, NY
National Provider Identifier
1609112978
Registry record updated Dec 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
005863 Issued in NY
Legal business name
NATHAN ASHBY DPM PLLC
Practice address
124 Margo LN
Fayetteville, NY 13066-1529
Phone
(315) 736-2080
NPI assigned
Dec 14, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2012

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

Authorized official

Name
Nathan Ashby, DPMNPI 1003995275
Title
Owner
Phone
(315) 736-2080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 005863 NY Primary

Addresses

Primary practice location

124 Margo LN
Fayetteville, NY 13066-1529

Mailing address

124 Margo LN
Fayetteville, NY 13066-1529
Phone (315) 736-2080

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130522000215 NY Part B Supplier - Clinic/Group Practice 4082852660 Receives reassigned benefits from 1 practitioner
Practice locations: Jamesville, NY; Syracuse, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1355443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355443200000",
    "number": "1609112978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 MARGO LN",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661529",
            "telephone_number": "315-736-2080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MARGO LN",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661529",
            "telephone_number": "315-736-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATHAN ASHBY DPM PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-14",
        "last_updated": "2012-12-14",
        "status": "A",
        "authorized_official_last_name": "ASHBY",
        "authorized_official_first_name": "NATHAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-736-2080",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "005863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.