Individual provider Active NPI

Ashley Dammer, LICSW

  • Clinical Social Worker
  • Hermantown, MN
National Provider Identifier
1750805347
Registry record updated Dec 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
23366 Issued in MN
Practice address
4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone
(218) 786-3540
NPI assigned
Jul 26, 2017
Last updated
Dec 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 9560-123 WI
Clinical Social Worker 1041C0700X 23366 MN Primary

Addresses

Primary practice location

4855 W Arrowhead Rd
Hermantown, MN 55811-3936

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

Other practice location 1

3500 Tower Ave
Superior, WI 54880-4491
Phone (715) 817-7100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, WI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190521000157 MN Practitioner - Clinical Social Worker 1052654712 Reassigns benefits to 2 organizations
I20211210000573 WI Practitioner - Clinical Social Worker 1052654712 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Duluth Clinic LTDGroup PAC ID 2567374283, 1,135 clinicians

Practice addresses (Care Compare)

4855 W Arrowhead Rd
Hermantown, MN 55811-3936
Phone (218) 786-3540

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23366MNMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
St. Mary's Hospital of Superior CurrentSince Jan 1, 2026 Accepting new patients
The Duluth Clinic LTD CurrentSince Jul 15, 2019 Accepting new patients
The Duluth Clinic, LTD Current Accepting new patients
SMDC Medical Center CurrentSince Jul 15, 2019 Accepting new patients
The Duluth Clinic, LTD. CurrentSince Jul 15, 2019 Accepting new patients
St. Mary's Hospital of Superior CurrentSince Dec 15, 2021 Accepting new patients
The Duluth Clinic LTD Current Accepting new patients

Locations

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

615 Pecan Ave
Duluth, MN 55811
Phone (218) 355-2100

4855 W Arrowhead Rd
Hermantown, MN 55811
Phone (218) 786-3540

3500 Tower Ave
Superior, WI 54880
Phone (715) 392-8281

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1501027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638403200000",
    "number": "1750805347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 UNIVERSITY DR S",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581034940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4855 W ARROWHEAD RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558113936",
            "telephone_number": "218-786-3540"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3500 Tower Ave",
            "address_purpose": "LOCATION",
            "city": "Superior",
            "state": "WI",
            "postal_code": "548804491",
            "country_code": "US",
            "telephone_number": "715-817-7100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAMMER",
        "first_name": "ASHLEY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-26",
        "last_updated": "2021-12-02",
        "certification_date": "2021-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "9560-123",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hermantown, MN

Sources for this page

Verify at the official NPI Registry.