Individual provider Active NPI

Ashley Marie Poole, PTA

  • Physical Therapy Assistant
  • Brandon, FL
National Provider Identifier
1629609474
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA28610 Issued in FL
Practice address
1129 Professional Park Dr
Brandon, FL 33511-4887
Phone
(813) 876-8771
NPI assigned
Jan 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA28610 FL Primary

Addresses

Primary practice location

1129 Professional Park Dr
Brandon, FL 33511-4887

Mailing address

8967 Indigo Trail Loop
Riverview, FL 33578-2303
Phone (352) 345-5122

Other practice location 1

13020 N Telecom Pkwy
Temple Terrace, FL 33637-0925
Phone (813) 978-9700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA28610FLMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pribila Consulting Services Inc CurrentSince Dec 3, 2023 Accepting new patients
University Community Hospital, Inc PastSince Feb 1, 2020 Accepting new patients
Therapeutic Rehab Specialists Inc. PastSince Dec 3, 2023 Accepting new patients

Locations

1129 Professional Park Dr
Brandon, FL 33511
Phone (813) 876-8771

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.

NPI Registry JSON

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

{
    "created_epoch": "1580342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1629609474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8967 INDIGO TRAIL LOOP",
            "city": "RIVERVIEW",
            "state": "FL",
            "postal_code": "335782303",
            "telephone_number": "352-345-5122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1129 PROFESSIONAL PARK DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114887",
            "telephone_number": "813-876-8771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13020 N Telecom Pkwy",
            "address_purpose": "LOCATION",
            "city": "Temple Terrace",
            "state": "FL",
            "postal_code": "336370925",
            "country_code": "US",
            "telephone_number": "813-978-9700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POOLE",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-30",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA28610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; 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.