Individual provider Active NPI

Ashley McClain Gose, P.A.

  • Physician Assistant
  • Three Rivers, MI
National Provider Identifier
1619038288
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601006385 Issued in MI
Practice address
850 S Health Parkway
Three Rivers, MI 49093-8358
Phone
(269) 279-5240
NPI assigned
Dec 13, 2006
Last updated
Nov 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 085-001923 IL
Physician Assistant 363A00000X 5601006385 MI Primary

Addresses

Primary practice location

850 S Health Parkway
Three Rivers, MI 49093-8358

Mailing address

3245 Health Dr Ste 100
Granger, IN 46530-1380

Other practice location 1

721 6th Ave Ste A
Three Rivers, MI 49093-8378
Phone (269) 273-9782

Other identifiers 1

IdentifierTypeStateIssuer
1619038288MedicaidMI

Other names 1

  • Ashley McClain Former name

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
I20140317001926 MI Practitioner - Physician Assistant 9638151376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Three Rivers Health System IncGroup PAC ID 8729245584, 42 clinicians

Practice addresses (Care Compare)

850 S Health Pkwy
Three Rivers, MI 49093-8358
Phone (269) 279-5240

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
085-001923ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Three Rivers Health System, Inc CurrentSince Nov 17, 2014 Accepting new patients
Three Rivers Health System, Inc CurrentSince Nov 17, 2014 Accepting new patients

Locations

3245 Health Dr
Ste 100
Granger, IN 46530
Phone (574) 647-2129

701 S Health Parkway
Three Rivers, MI 49093
Phone (269) 273-9691

711 S Health Parkway
Ste 1
Three Rivers, MI 49093
Phone (269) 273-6400

711 S Health Parkway
Ste L7
Three Rivers, MI 49093
Phone (269) 273-9640

721 6th Ave
Ste A
Three Rivers, MI 49093
Phone (269) 273-1418

850 S Health Parkway
Three Rivers, MI 49093
Phone (269) 279-5240

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1619038288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 HEALTH DR STE 100",
            "city": "GRANGER",
            "state": "IN",
            "postal_code": "465301380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 S HEALTH PARKWAY",
            "city": "THREE RIVERS",
            "state": "MI",
            "postal_code": "490938358",
            "telephone_number": "269-279-5240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "721 6th Ave Ste A",
            "address_purpose": "LOCATION",
            "city": "Three Rivers",
            "state": "MI",
            "postal_code": "490938378",
            "country_code": "US",
            "telephone_number": "269-273-9782",
            "fax_number": "269-273-9711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOSE",
        "first_name": "ASHLEY",
        "middle_name": "MCCLAIN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085-001923",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601006385",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619038288",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "MCCLAIN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Three Rivers, MI

Sources for this page

Verify at the official NPI Registry.