Ashley Rose Shutack, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

4 Bree Dr
Hamilton Square, NJ 08690-1502

Phone

(609) 529-3454

NPI assigned

Nov 26, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601596800000",
    "number": "1609346386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 BREE DR",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086901502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 BREE DR",
            "city": "HAMILTON SQUARE",
            "state": "NJ",
            "postal_code": "086901502",
            "telephone_number": "609-529-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHUTACK",
        "first_name": "ASHLEY",
        "middle_name": "ROSE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2020-10-02",
        "certification_date": "2020-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HORIZON BLUE CROSS BLUE SHIELD",
            "identifier": "NJX3HZN34669260",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Serv Achievement Centers, Inc
• Theodore F Shafman, O.D.
• Sharon a Manto OD PC
• Nina Shimunov, OD
• Rohini Shivkumar
• Aniela Siniakowicz, D.D.S.
• Robert Miroslaw Siniakowicz, MD
• Soriero Family Chiropractic PA (Anthony C Soriero D.C. P.A.)
• Anthony C. Soriero, D.C.
• Mitchel B Sosis, MD

• Athletic Trainer in Hamilton Square, NJ
• Providers in Hamilton Square, NJ by specialty
• Athletic Trainer in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2020; 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.