Individual provider Active NPI

Ashley Elizabeth Prosser, DPT

  • Pediatric Physical Therapist
  • Hixson, TN
National Provider Identifier
1679889984
Registry record updated May 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
9734 Issued in TN
Practice address
5819 Winding LN Ste 101
Hixson, TN 37343-4067
Phone
(615) 512-8448
Fax
(800) 470-1905
NPI assigned
Aug 24, 2010
Last updated
May 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 010095 GA
Pediatric Physical Therapist 2251P0200X 9734 TN Primary

Addresses

Primary practice location

5819 Winding LN Ste 101
Hixson, TN 37343-4067

Mailing address

5819 Winding LN Ste 101
Hixson, TN 37343-4067
Phone (615) 512-8448

Other practice location 1

118 Herron St
Ft Oglethorpe, GA 30742-3126
Phone (706) 861-7471

Other practice location 2

118 Herron St
Ft Oglethorpe, GA 30742-3126
Phone (706) 861-7471

Other practice location 3

1835 W Central Rd
Arlington Heights, IL 60005-2410
Phone (847) 870-7711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221220002146 TN Practitioner - Physical Therapist in Private Practice 6608257860

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9734TNMDGeneral Practice Dentistry
010095GAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Pathways, LLC CurrentSince May 29, 2022 Accepting new patients
North Georgia Pediatric Therapies, LLC Past Accepting new patients

Locations

5819 Winding Ln
Ste 101
Hixson, TN 37343
Phone (423) 877-5042

5819 Winding Ln
Ste 105
Hixson, TN 37343
Phone (423) 645-2746

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, 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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653523200000",
    "number": "1679889984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5819 WINDING LN STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434067",
            "telephone_number": "615-512-8448",
            "fax_number": "800-470-1905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5819 WINDING LN STE 101",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373434067",
            "telephone_number": "615-512-8448",
            "fax_number": "800-470-1905"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "118 Herron St",
            "address_purpose": "LOCATION",
            "city": "Ft Oglethorpe",
            "state": "GA",
            "postal_code": "307423126",
            "country_code": "US",
            "telephone_number": "706-861-7471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "118 Herron St",
            "address_purpose": "LOCATION",
            "city": "Ft Oglethorpe",
            "state": "GA",
            "postal_code": "307423126",
            "country_code": "US",
            "telephone_number": "706-861-7471",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1835 W Central Rd",
            "address_purpose": "LOCATION",
            "city": "Arlington Heights",
            "state": "IL",
            "postal_code": "600052410",
            "country_code": "US",
            "telephone_number": "847-870-7711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PROSSER",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2022-05-26",
        "certification_date": "2022-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "010095",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "9734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.