Individual provider Active NPI

Ashley L Kubik, NP-C

  • Family Nurse Practitioner
  • Springfield, MO
National Provider Identifier
1619010063
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
127680 Issued in MO
Practice address
1235 E Cherokee St
Springfield, MO 65804-2203
Phone
(417) 820-6525
NPI assigned
Feb 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 127680 MO Primary

Addresses

Primary practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 2580
Springfield, MO 65801-2580
Phone (417) 829-4620

Other identifiers 4

IdentifierTypeStateIssuer
424658805MedicaidMO
139092OtherMOMO BLUE SHIELD
82346OtherARARK BLUE SHIELD
159925758MedicaidAR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20031121000780 MO Practitioner - Nurse Practitioner 9133023047 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Clinic Springfield CommunitiesGroup PAC ID 7416865845, 1,121 clinicians

Practice addresses (Care Compare)

1235 E Cherokee St
Springfield, MO 65804-2203

2115 S Fremont Ave
3050 MC Infectious Disease Whiteside
Springfield, MO 65804-2236
Phone (417) 820-3905

Hospital & facility affiliations

  • Mercy Hospital Springfield Hospital, Springfield, MO, CCN 260065

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
127680MOMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinic Springfield Communities Family CurrentSince Sep 1, 2000 Accepting new patients
Mercy Clinic Springfield Communities CurrentSince Sep 1, 2000 Accepting new patients

Locations

1605 Martin Springs Dr
Ste 330
Rolla, MO 65401
Phone (573) 458-6379

1235 E Cherokee St
Ste 3E
Springfield, MO 65804

2115 S Fremont Ave
Ste 3050
Springfield, MO 65804
Phone (417) 820-3905

1235 E Cherokee St
Springfield, MO 65804
Phone (417) 820-2115

Interoperability endpoints

  • Direct secure messaging: akubik772@directb.mercy.net

Organizations & group practices 2

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 9

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": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1619010063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1235 E CHEROKEE ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658042203",
            "telephone_number": "417-820-6525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUBIK",
        "first_name": "ASHLEY",
        "middle_name": "L",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "127680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "424658805",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MO BLUE SHIELD",
            "identifier": "139092",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARK BLUE SHIELD",
            "identifier": "82346",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159925758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MO

Sources for this page

Verify at the official NPI Registry.