Roberta Ashley Ekholm, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS14892 Issued in FL

Practice address

300 Clyde Morris Blvd Ste a
Ormond Beach, FL 32174-5909

Phone

(386) 317-8620

Fax

(386) 317-8625

NPI assigned

Sep 20, 2006

Last updated

Jan 18, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/24970/brand/1/csg/1/fhir/r4

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.

• Action Urgent Care Inc

  • Urgent Care Clinic/Center
  • San Jose, CA
  • NPI 1205186442
  NPD (past)
• Orohealth Corporation a Non Profit Healthcare System

  dba Orohealth Professional Group

  • Family Medicine Physician
  • Oroville, CA
  • NPI 1013933167
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705536000000",
    "number": "1780781609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-317-8620",
            "fax_number": "386-317-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CLYDE MORRIS BLVD STE A",
            "city": "ORMOND BEACH",
            "state": "FL",
            "postal_code": "321745909",
            "telephone_number": "386-317-8620",
            "fax_number": "386-317-8625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKHOLM",
        "first_name": "ROBERTA",
        "middle_name": "ASHLEY",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-01-18",
        "certification_date": "2023-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS14892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• East Coast Pathology of Florida, PA
• East Coast Podiatry Inc
• Eastern Shores Orthopedic Brace Inc
• Riley Eddy
• George Lawrence Ehringer, M.D.
• Ela Therapy Solutions, Inc.
• Elite Eyecare Incorporated
• Elite Physical Therapy Associates, LLC (Elite Physical Therapy)
• Elizabeth Krochak MD PA
• Elizabeth Morejon, DMD, Ms, PA

• Family Medicine Physician in Ormond Beach, FL
• Providers in Ormond Beach, FL by specialty
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.