Ashley Elizabeth Peterson, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

7825544-4405 Issued in UT

Practice address

115 Golf Course Rd Ste E
Logan, UT 84321-5934

Phone

(435) 999-4059

NPI assigned

Sep 29, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Martin Medical Group LLCGroup PAC ID 4284099177, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Martin Medical Group LLC

  • Physician Assistant
  • Logan, UT
  • NPI 1467081448

  Family Medicine

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632873600000",
    "number": "1720750615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 GOLF COURSE RD STE E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 GOLF COURSE RD STE E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843215934",
            "telephone_number": "435-999-4059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSON",
        "first_name": "ASHLEY",
        "middle_name": "ELIZABETH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2021-09-29",
        "certification_date": "2021-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "7825544-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rilee Diane Perrett, LCSW
• Jenika A. Perry, CSW
• Chase B Petersen, M.D.
• Kent H Petersen, PHARM.D.
• Tyson Don Petersen, D.D.S.
• Brent E. Peterson, D.C.
• Cameron Glade Peterson, M.D.
• David Erik Peterson, MD
• Frank E Peterson, M.D.
• Justin Peterson, MD

• Family Nurse Practitioner in Logan, UT
• Providers in Logan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2021; 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.
• 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.