Ashley Carpenter, NP
Individual provider Active NPI Family Nurse Practitioner · Festus, MO
NPI 1720526692 · NPPES record last updated Jan 7, 2019
Key facts
- NPI
- 1720526692
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2016037719 (MO)
- Practice address
- 1390 US Highway 61 Ste N-1000
Festus, MO 63028-4136 - Phone
- (636) 933-9300
- NPI assigned
- Feb 10, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Citizens Memorial Healthcare
Practice addresses (Care Compare)
Bolivar, MO 65613
Phone (417) 328-6631
Hospital & facility affiliations
- Citizens Memorial Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170830002695 | MO | Practitioner - Nurse Practitioner | 9638442494 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010019383 | MO | MD | Registered Nurse |
| 2016037719 | MO | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Citizens Memorial Healthcare | Current |
Accepting new patients | |
| Citizens Memorial Healthcare | Current |
Accepting new patients |
Locations
1195 N Oakland Ave
Bolivar, MO 65613
Phone (417) 777-2121
1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000
1155 W Parkview St
Ste 1C
Bolivar, MO 65613
Phone (417) 326-7246
1155 W Parkview St
Ste 2D
Bolivar, MO 65613
Phone (417) 777-2663
Interoperability endpoints
- ashley.carpenter@115443077021700.direct.elationemr.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 2010019383 | MO | |
| Nurse Practitioner | 363L00000X | 2016037719 | MO | |
| Family Nurse Practitioner | 363LF0000X | 2016037719 | MO | Yes |
Addresses
Primary practice location
1390 US Highway 61 Ste N-1000
Festus, MO 63028-4136
Mailing address
1390 US Highway 61 Ste N-1000
Festus, MO 63028-4136
Phone (636) 933-9300
Other names
- Ashley Pippin
Other providers in Festus, MO
- Anne Caputa
- Eric Jaques Carbonell
- Care Bridg Home Care
- Jessica B Carlstrom
- Kasey L Carnes
- Amanda Lynn Carroll
- Carolyn Carter
- Susan C. Cassimatis
- Whitney Cawvey
- Ccpartners LLC
All providers in Festus, MO · Family Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.