Individual provider Active NPI

Tice Ashurst, D.O.

  • Emergency Medicine Physician
  • Hershey, PA
National Provider Identifier
1689968984
Registry record updated Oct 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
OT014277 Issued in PA
Practice address
500 University Dr
Hershey, PA 17033-2360
Phone
(717) 531-8521
NPI assigned
Jun 3, 2011
Last updated
Oct 30, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 02004412A IN
Emergency Medicine Physician 207P00000X OT014277 PA Primary

Addresses

Primary practice location

500 University Dr
Hershey, PA 17033-2360

Mailing address

500 University Dr
Hershey, PA 17033-2360
Phone (717) 531-8521

Other practice location 1

7950 W Jefferson Blvd
Fort Wayne, IN 46804-4140
Phone (260) 435-2699

Other identifiers 1

IdentifierTypeStateIssuer
0118784MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140515001842 IN Practitioner - Emergency Medicine 6608099833 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OT014277PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Professionals of Indiana, P.C. Emergency Medicine CurrentSince Aug 1, 2023 Accepting new patients
Marion General Hospital Current Accepting new patients
Innovative Hospital Care, LLC Past Accepting new patients

Locations

3700 Washington Ave
Evansville, IN 47714
Phone (812) 232-0021

2520 E DuPont Rd
Fort Wayne, IN 46825
Phone (219) 407-8000

6515 Stellhorn Rd
Fort Wayne, IN 46815
Phone (260) 435-7001

702 Van Buren St
Fort Wayne, IN 46802
Phone (260) 425-3000

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

4781 Kaybee Dr
Gas City, IN 46933
Phone (765) 660-7840

330 N Wabash Ave
Ste G-20
Marion, IN 46952
Phone (765) 660-7600

441 N Wabash Ave
Marion, IN 46952
Phone (219) 482-4577

85 E US Highway 6
Valparaiso, IN 46383
Phone (219) 983-5743

2101 Dubois Dr
Warsaw, IN 46580
Phone (219) 267-3200

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, 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": "1307059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761782400000",
    "number": "1689968984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 UNIVERSITY DR",
            "city": "HERSHEY",
            "state": "PA",
            "postal_code": "170332360",
            "telephone_number": "717-531-8521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7950 W Jefferson Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Wayne",
            "state": "IN",
            "postal_code": "468044140",
            "country_code": "US",
            "telephone_number": "260-435-2699",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASHURST",
        "first_name": "TICE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-03",
        "last_updated": "2025-10-30",
        "certification_date": "2025-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "02004412A",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT014277",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0118784",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hershey, PA

Sources for this page

Verify at the official NPI Registry.