Individual provider Active NPI

Ashlyn Coffey Smith

  • Medical Physician Assistant
  • Gainesville, GA
National Provider Identifier
1770124901
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
10035 Issued in GA
Practice address
1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806
Phone
(678) 430-3110
NPI assigned
Sep 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 10035 GA Primary

Addresses

Primary practice location

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806

Mailing address

1475 Jesse Jewell Pkwy NE Ste 300
Gainesville, GA 30501-3806

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20201204001500 GA Practitioner - Physician Assistant 8527479070 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia Col of Osteo Med, Sewanee, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular Clinic of North Georgia PCGroup PAC ID 9830350735, 11 clinicians

Practice addresses (Care Compare)

1475 Jesse Jewell Pkwy NE
Gainesville, GA 30501-3806

5670 Old Winder Hwy
Suite 200
Braselton, GA 30517-1240
Phone (678) 430-3110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1569715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1770124901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 JESSE JEWELL PKWY NE STE 300",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013806",
            "telephone_number": "678-430-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "ASHLYN",
        "middle_name": "COFFEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "10035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.