Ashley Blalock

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

21250 Issued in TN

Practice address

4903 Bruceville Slab Rd
Friendship, TN 38034-4325

Phone

(731) 676-0393

NPI assigned

Feb 8, 2016

Last updated

Apr 15, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: acreasy@mh-tn.direct.office.nextgen.com
• FHIR API: https://fhir-usa.unify.chbase.com/org/lauderd-6f671ec9

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.

• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Emergency Care Clinic/Center
  • Ripley, TN
  • NPI 1962034272
  Medicare reassignment NPD
• Southeastern Physician Services PC

  • Hospitalist Physician
  • Oak Ridge, TN
  • NPI 1083835441
  Medicare reassignment NPD
• Beyond Beauty , LLC

  • Clinic/Center
  • Dyersburg, TN
  • NPI 1992566426
  NPD Authorized official
• Mobile Healing LLC

  • Primary Care Nurse Practitioner
  • Friendship, TN
  • NPI 1750921003
  NPD Authorized official
• Lauderdale Community Hospital LLC

  dba Lauderdale Community Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Ripley, TN
  • NPI 1356973663
  NPD
• Cane Ridge Emergency Physicians LLC

  • Emergency Medicine Physician
  • Smyrna, TN
  • NPI 1275815433
  NPD (past)

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

{
    "created_epoch": "1454889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649980800000",
    "number": "1679931414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2373 AUGUSTA ST",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380248942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4903 BRUCEVILLE SLAB RD",
            "city": "FRIENDSHIP",
            "state": "TN",
            "postal_code": "380344325",
            "telephone_number": "731-676-0393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLALOCK",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-08",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "21250",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "21250",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1679931414",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allcare Medical PLLC
• Penny Gateley Creekmore, FNP
• Madelyne Ellis, FNP
• Hamilton York Haley, D.PH.
• Hamilton York Haley
• Madison Transport

• Primary Care Nurse Practitioner in Friendship, TN
• Providers in Friendship, TN by specialty
• Primary Care Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.