Individual provider Active NPI

Ashley Everson, LSW

  • Social Worker
  • Devils Lake, ND
National Provider Identifier
1669793352
Registry record updated Nov 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
4447 Issued in ND
Practice address
1820 Walnut St E Ste 5
Devils Lake, ND 58301-3411
Phone
(701) 662-4913
Fax
(701) 662-4963
NPI assigned
Jun 16, 2010
Last updated
Nov 2, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4447 ND Primary

Addresses

Primary practice location

1820 Walnut St E Ste 5
Devils Lake, ND 58301-3411

Mailing address

1820 Walnut St E Ste 5
Devils Lake, ND 58301-3411
Phone (701) 662-4913

Other identifiers 1

IdentifierTypeStateIssuer
1452193MedicaidND

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
4447NDMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1509580800000",
    "number": "1669793352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1820 WALNUT ST E STE 5",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013411",
            "telephone_number": "701-662-4913",
            "fax_number": "701-662-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 WALNUT ST E STE 5",
            "city": "DEVILS LAKE",
            "state": "ND",
            "postal_code": "583013411",
            "telephone_number": "701-662-4913",
            "fax_number": "701-662-4963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSON",
        "first_name": "ASHLEY",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-16",
        "last_updated": "2017-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "ND",
            "license": "4447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1452193",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Devils Lake, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2017; 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.