Individual provider Active NPI

Ashley Adams Little, PHYSICIAN ASSITANT

  • Medical Physician Assistant
  • Bogalusa, LA
National Provider Identifier
1770705121
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
200245 Issued in LA
Practice address
617 Avenue F
Bogalusa, LA 70427-3637
Phone
(985) 730-6970
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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 200245 LA Primary

Addresses

Primary practice location

617 Avenue F
Bogalusa, LA 70427-3637

Mailing address

433 Plaza St
Bogalusa, LA 70427-3729

Other practice location 1

400 Memphis St
Bogalusa, LA 70427-3862
Phone (985) 730-6711

Other identifiers 2

IdentifierTypeStateIssuer
009937454MedicaidAL
51531248OtherALBCBS CCH

Other names 1

  • Ashley Elizabeth Waggoner Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address alittle14632@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20081021000652 LA Practitioner - Physician Assistant 7517924376 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Our Lady of the Angels Hospital IncGroup PAC ID 7012144322, 78 clinicians

Practice addresses (Care Compare)

433 Plaza St
Bogalusa, LA 70427-3729
Phone (985) 730-6706

617 Ave F
Bogalusa, LA 70427-3637
Phone (985) 730-6706

Hospital & facility affiliations

  • Pulse Home Health Care Home health agency, Covington, LA, CCN 197179
  • Our Lady of the Angels Hospital Hospital, Bogalusa, LA, CCN 190312
  • Riverside Medical Center Hospital, Franklinton, LA, CCN 191313

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
200245LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 16, 2018 Accepting new patients
Our Lady of the Angels Hospital, Inc. Physician Assistant CurrentSince Mar 17, 2014 Accepting new patients
Wash-St Tammany Reg Medical Center Physician Assistant Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Jul 16, 2018 Accepting new patients
Wilburn a. Smith, Jr., M.D. Past Accepting new patients
Vital Surg LLC Past Accepting new patients
Our Lady of the Lake Physician Group LLC Physician Assistant Past Accepting new patients
Washington St. Tammany Regional Medical Center Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

433 Plaza St
Fl 3
Bogalusa, LA 70427
Phone (985) 730-6710

617 Avenue F
Bogalusa, LA 70427
Phone (985) 545-1070

106 Avenue B
Ste A
Bogalusa, LA 70427

1416 Gobbler Head Dr
Bogalusa, LA 70427
Phone (985) 730-6970

433 Plaza St
Bogalusa, LA 70427
Phone (985) 730-6700

400 Memphis St
Bogalusa, LA 70427
Phone (504) 568-4937

70411 Highway 21
Covington, LA 70433
Phone (985) 288-5088

Interoperability endpoints

  • Direct secure messaging: alittle14632@direct.casso.us.com

Organizations & group practices 9

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 8

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1770705121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "433 PLAZA ST",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "617 AVENUE F",
            "city": "BOGALUSA",
            "state": "LA",
            "postal_code": "704273637",
            "telephone_number": "985-730-6970"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 Memphis St",
            "address_purpose": "LOCATION",
            "city": "Bogalusa",
            "state": "LA",
            "postal_code": "704273862",
            "country_code": "US",
            "telephone_number": "985-730-6711",
            "fax_number": "985-730-6713",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LITTLE",
        "first_name": "ASHLEY",
        "middle_name": "ADAMS",
        "credential": "PHYSICIAN ASSITANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "200245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009937454",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS CCH",
            "identifier": "51531248",
            "state": "AL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "alittle14632@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "alittle14632@direct.casso.us.com",
            "address_1": "617 Avenue F",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273637",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "617 Avenue F",
            "city": "Bogalusa",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704273637",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "WAGGONER",
            "middle_name": "ELIZABETH",
            "credential": "PHYSICIAN ASSITANT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bogalusa, LA

Sources for this page

Verify at the official NPI Registry.