Individual provider Active NPI

Kaitlin M Ashley, PA-C

  • Physician Assistant
  • Sioux Falls, SD
National Provider Identifier
1679359202
Registry record updated Feb 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1471 Issued in SD
Practice address
1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone
(605) 322-2000
NPI assigned
Sep 8, 2023
Last updated
Feb 14, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1471 SD Primary

Addresses

Primary practice location

1325 S Cliff Ave
Sioux Falls, SD 57105-1007

Mailing address

1325 S Cliff Ave
Sioux Falls, SD 57105-1007
Phone (605) 322-2000

Other names 1

  • Kaitlin M Lang Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SD
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
I20231221001811 SD Practitioner - Physician Assistant 1153771894 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1471SDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Avera McKennan CurrentSince Jan 1, 2024 Accepting new patients
Avera McKennan CurrentSince Jan 1, 2024 Accepting new patients
Sanford Medical Center CurrentSince Nov 8, 2023 Accepting new patients

Locations

300 W 5th St
Miller, SD 57362
Phone (605) 853-0158

1325 S Cliff Ave
Sioux Falls, SD 57105
Phone (605) 322-5000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707868800000",
    "number": "1679359202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 S CLIFF AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571051007",
            "telephone_number": "605-322-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHLEY",
        "first_name": "KAITLIN",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2024-02-14",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SD",
            "license": "1471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAITLIN",
            "last_name": "LANG",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.