Individual provider Active NPI

Ashley N Fetrow, DPT

  • Physical Therapist
  • Deming, NM
National Provider Identifier
1609267194
Registry record updated Feb 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4592 Issued in NM
Practice address
722 E Florida St
Deming, NM 88030-5310
Phone
(575) 546-2555
Fax
(575) 546-2725
NPI assigned
Feb 5, 2015
Last updated
Feb 5, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 4592 NM Primary

Addresses

Primary practice location

722 E Florida St
Deming, NM 88030-5310

Mailing address

722 E Florida St
Deming, NM 88030-5310
Phone (575) 546-2555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150402000275 NM Practitioner - Physical Therapist in Private Practice 1850618778 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Rehabilitation LLCGroup PAC ID 1052592482, 2 clinicians

Practice addresses (Care Compare)

722 E Florida St
Deming, NM 88030-5310
Phone (575) 546-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4592NMMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Rehabilitation LLC Physical Therapist CurrentSince Feb 5, 2015 Accepting new patients

Locations

722 E Florida St
Deming, NM 88030
Phone (505) 546-2555

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1423094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423094400000",
    "number": "1609267194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 E FLORIDA ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880305310",
            "telephone_number": "575-546-2555",
            "fax_number": "575-546-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 E FLORIDA ST",
            "city": "DEMING",
            "state": "NM",
            "postal_code": "880305310",
            "telephone_number": "575-546-2555",
            "fax_number": "575-546-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FETROW",
        "first_name": "ASHLEY",
        "middle_name": "N",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-05",
        "last_updated": "2015-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "4592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deming, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.