Individual provider Active NPI

Ashley Brooke Tunstall, FNP

  • Nurse Practitioner
  • Longview, TX
National Provider Identifier
1770134561
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP140933 Issued in TX
Practice address
802 Medical Dr Ste 401
Longview, TX 75605-5206
Phone
(903) 553-7680
Fax
(903) 553-7688
NPI assigned
Sep 24, 2019
Last updated
Aug 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP140933 TX Primary

Addresses

Primary practice location

802 Medical Dr Ste 401
Longview, TX 75605-5206

Mailing address

802 Medical Dr Ste 401
Longview, TX 75605-5206
Phone (903) 553-7680

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20191105001380 TX Practitioner - Nurse Practitioner 1951633353 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regional Clinics of LongviewGroup PAC ID 7214016559, 38 clinicians

Practice addresses (Care Compare)

1009 N 4TH St
Suite a
Longview, TX 75601-4768
Phone (903) 757-3808

2901 4TH St
Longview, TX 75605-5128
Phone (903) 758-1818

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2019 Accepting new patients
Regional Clinics of Longview CurrentSince Apr 17, 2023 Accepting new patients
Etmc Physician Group Inc. CurrentSince Oct 1, 2019 Accepting new patients
Starks Medical PastSince Sep 29, 2019 Accepting new patients
Diagnostic Clinic of Longview PA Past Accepting new patients

Locations

18118 FM 344 W
Flint, TX 75762
Phone (903) 825-3292

1009 N 4th St
Ste A
Longview, TX 75601
Phone (903) 757-3808

1806 E End Blvd N
Marshall, TX 75670
Phone (903) 524-0917

700 Olympic Plaza Cir
Ste 420
Tyler, TX 75701
Phone (903) 526-2500

Interoperability endpoints

  • Direct secure messaging: ashley.tunstall.1@16432.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/23550/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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.

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": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723420800000",
    "number": "1770134561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "802 MEDICAL DR STE 401",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055206",
            "telephone_number": "903-553-7680",
            "fax_number": "903-553-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 MEDICAL DR STE 401",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055206",
            "telephone_number": "903-553-7680",
            "fax_number": "903-553-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUNSTALL",
        "first_name": "ASHLEY",
        "middle_name": "BROOKE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TX",
            "license": "AP140933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.