Individual provider Active NPI

Ashley Morris Wicks, P.A.

  • Physician Assistant
  • St Petersburg, FL
National Provider Identifier
1699052118
Registry record updated Sep 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9106183 Issued in FL
Practice address
2191 9TH Ave N
Suite 200
St Petersburg, FL 33713-7146
Phone
(727) 327-0990
Fax
(727) 327-0895
NPI assigned
Nov 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2020

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 PA9106183 FL Primary

Addresses

Primary practice location

2191 9TH Ave N
Suite 200
St Petersburg, FL 33713-7146

Mailing address

2191 9TH Ave N
Ste 235
St Petersburg, FL 33713-7152
Phone (813) 977-0733

Other identifiers 1

IdentifierTypeStateIssuer
PA9106183OtherFLSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20190108000261 FL Practitioner - Physician Assistant 5496091779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Walter G Griffith Jr MD PAGroup PAC ID 9537237029, 7 clinicians

Practice addresses (Care Compare)

5565 Dr Martin Luther King Jr St N
St Petersburg, FL 33703-1203

5565 Dr MLK Jr St N
St Petersburg, FL 33703-1203
Phone (727) 577-1203

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA9106183FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Learning to Achieve Wellness Inc PastSince Jan 1, 2025 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1320969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598918400000",
    "number": "1699052118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 9TH AVE N",
            "address_2": "STE 235",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137152",
            "telephone_number": "813-977-0733",
            "fax_number": "813-971-2230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 9TH AVE N",
            "address_2": "SUITE 200",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337137146",
            "telephone_number": "727-327-0990",
            "fax_number": "727-327-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "ASHLEY",
        "middle_name": "MORRIS",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-11",
        "last_updated": "2020-09-01",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9106183",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA9106183",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.