Individual provider Active NPI

Ashley Gary, PA-C

  • Medical Physician Assistant
  • Grand Rapids, MI
National Provider Identifier
1609207091
Registry record updated Mar 5, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
5601006882 Issued in MI
Practice address
669 Stocking Ave NW
Grand Rapids, MI 49504-5176
Phone
(616) 235-1480
NPI assigned
Dec 10, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 5, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 5601006882 MI Primary

Addresses

Primary practice location

669 Stocking Ave NW
Grand Rapids, MI 49504-5176

Mailing address

669 Stocking Ave NW
Grand Rapids, MI 49504-5176
Phone (616) 235-1480

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20140204001647 MI Practitioner - Physician Assistant 8022247477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cherry Street Services IncGroup PAC ID 6800707647, 58 clinicians

Practice addresses (Care Compare)

550 Cherry St SE
Grand Rapids, MI 49503-4748
Phone (616) 235-7272

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherry Street Services, Inc CurrentSince Jan 13, 2014 Accepting new patients
Cherry Street Services, Inc. CurrentSince Jan 13, 2014 Accepting new patients
Cherry Street Health Services Past Accepting new patients

Locations

100 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 965-8209

550 Cherry St SE
Grand Rapids, MI 49503
Phone (616) 235-7272

669 Stocking Ave NW
Grand Rapids, MI 49504
Phone (616) 235-1480

Interoperability endpoints

  • Direct secure messaging: ashley.gary.p1@direct.cherryhealth.nextgenshare.com

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.

Hospital & facility affiliations 2

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": "1386633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488672000000",
    "number": "1609207091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 STOCKING AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045176",
            "telephone_number": "616-235-1480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 STOCKING AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045176",
            "telephone_number": "616-235-1480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARY",
        "first_name": "ASHLEY",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-10",
        "last_updated": "2017-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MI",
            "license": "5601006882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.