Individual provider Active NPI

Ashley L Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Bentonville, AR
National Provider Identifier
1720647357
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
123885 Issued in AR
Practice address
3000 Medical Center Pkwy
Bentonville, AR 72712-3217
Phone
(479) 553-1000
NPI assigned
Jun 7, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine Registered Nurse 163WC0200X 2017013795 MO
Certified Registered Nurse Anesthetist 367500000X 2019025793 MO
Certified Registered Nurse Anesthetist 367500000X 123885 AR Primary

Addresses

Primary practice location

3000 Medical Center Pkwy
Bentonville, AR 72712-3217

Mailing address

PO Box 583
Lowell, AR 72745-0583
Phone (888) 991-1101

Other names 1

  • Ashley L Fraka Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS, AR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20190829003189 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547598476 Reassigns benefits to 1 organization
I20190904000670 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547598476 Reassigns benefits to 1 organization
I20200221001582 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547598476 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

3000 Medical Ctr Pkwy
Bentonville, AR 72712-3217
Phone (479) 757-4000

700 W Grove St
Medical Center of South Arkansas
El Dorado, AR 71730-4416
Phone (870) 863-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2017013795MOMDCritical Care Medicine Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Aug 24, 2025 Accepting new patients
Chase Placek Floyd Meggers Nurse Anesthetist, Certified Registered CurrentSince Feb 17, 2020 Accepting new patients
Capital Anesthesia Solutions of Arkansas, LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 4, 2023 Accepting new patients
Johnson Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
Anesthesia Associates of Kansas City PA CurrentSince Aug 21, 2019 Accepting new patients
Johnson Regional Medical Center CurrentSince Nov 1, 2022 Accepting new patients
Northeast Arkansas Clinic Charitable Foundation, Inc. PastSince Feb 9, 2020 Accepting new patients

Locations

3000 Medical Center Pkwy
Fl 2
Bentonville, AR 72712

3000 Medical Center Pkwy
Bentonville, AR 72712
Phone (479) 553-2524

1100 E Poplar St
Ste B
Clarksville, AR 72830
Phone (479) 754-5454

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

603 N Progress Ave
Siloam Springs, AR 72761
Phone (479) 215-3000

609 W Maple Ave
Springdale, AR 72764
Phone (479) 751-5711

601 W Maple Ave
Ste 503
Springdale, AR 72764
Phone (479) 751-3722

8717 W 110th St
Ste 600
Overland Park, KS 66210
Phone (913) 428-2910

10730 Nall Ave
Ste 100
Overland Park, KS 66211
Phone (913) 428-9000

2316 E Meyer Blvd
Kansas City, MO 64132
Phone (816) 276-4360

2100 SE Blue Pkwy
Lees Summit, MO 64063
Phone (816) 282-5175

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1559865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1720647357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 583",
            "city": "LOWELL",
            "state": "AR",
            "postal_code": "727450583",
            "telephone_number": "888-991-1101",
            "fax_number": "903-787-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 MEDICAL CENTER PKWY",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727123217",
            "telephone_number": "479-553-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ASHLEY",
        "middle_name": "L",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-07",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "MO",
            "license": "2017013795",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2019025793",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AR",
            "license": "123885",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "FRAKA",
            "middle_name": "L",
            "credential": "CRNA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bentonville, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.