Ashley Kyle Wasserman, D.M.D

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

5912 Issued in AL

Practice address

4547 Saint Stephens Rd
Eight Mile, AL 36613-3563

Phone

(251) 456-1399

Fax

(251) 456-0079

NPI assigned

Apr 11, 2012

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 3

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373328000000",
    "number": "1700142015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2867",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366522867",
            "telephone_number": "251-690-8158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4547 SAINT STEPHENS RD",
            "city": "EIGHT MILE",
            "state": "AL",
            "postal_code": "366133563",
            "telephone_number": "251-456-1399",
            "fax_number": "251-456-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WASSERMAN",
        "first_name": "ASHLEY",
        "middle_name": "KYLE",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-11",
        "last_updated": "2013-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "AL",
            "license": "5912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "630000013",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAIN GROUP MEDICARE PAYEE NUMBER",
            "identifier": "011846",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI MAIN GROUP PAYEE NUMBER",
            "identifier": "1063439065",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Grace Home Health & Hospice
• Southern Grace Home Health & Hospice LLC
• Summers Home Health Services ,LLC
• Ryann Sylvester
• The Learning Tree, Inc.

• Public Health Dentistry in Eight Mile, AL
• Providers in Eight Mile, AL by specialty
• Public Health Dentistry in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2013; 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.