Active NPI
Kellan E Ashley, MD
- Interventional Cardiology Physician
- Jackson, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Cardiology Physician
- License
- 18726
- Practice address
- 2500 N State Street
Cardiology
Jackson, MS 39216-4500 - Phone
- (601) 984-5678
- Fax
- (601) 984-5638
- NPI assigned
- Jul 1, 2006
- Last updated
- Oct 6, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 57.011859 | OH | |
| Cardiovascular Disease Physician | 207RC0000X | 18726 | MS | |
| Cardiovascular Disease Physician | 207RC0000X | 33296 | AL | |
| Interventional Cardiology Physician | 207RI0011X | 33296 | AL | |
| Interventional Cardiology Physician | 207RI0011X | 18726 | MS | Primary |
Addresses
Primary practice location
2500 N State Street
Cardiology
Jackson, MS 39216-4500
Mailing address
2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5678
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 130850 | Medicaid | AL | |
| P01233203 | Other | MS | RAILROAD MEDICARE |
| 04034504 | Medicaid | MS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Interventional Cardiology
- Education
- University of Mississippi School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775
Hospital & facility affiliations
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary angioplasty and stenting | 17 |
| Leg revascularization (restoring blood flow) | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18726 | MS | MD | Cardiovascular Disease Physician |
| 57.011859 | OH | MD | Cardiovascular Disease Physician |
| 33296 | AL | MD | Interventional Cardiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wayne General Hospital | Current | Accepting new patients | |
| Cardiology Associates of Mobile Inc | Cardiovascular Disease | Current | Accepting new patients |
| Wayne General Hospital | Current | Accepting new patients | |
| Wayne General Hospital | Current | Accepting new patients | |
| Ms Methodist Hospital & Rehabilitation Center | Cardiovascular Disease | Past | Accepting new patients |
| University Physicians, PLLC | Past | Accepting new patients | |
| Mississippi Methodist Hospital & Rehabilitation Center, Inc. | Past | Accepting new patients |
Locations
188 Hospital Dr
Ste 205
Fairhope, AL 36532
Phone (251) 990-3701
6701 Airport Blvd
Ste D330
Mobile, AL 36608
Phone (251) 607-9797
950 Matthew Dr
Waynesboro, MS 39367
Phone (601) 735-5151
Interoperability endpoints
- https://fhir.cardassoc.com/R4/open-R4
- kashley9967@ummc.direct-ci.com
Organizations & group practices 8
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.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
dba Wayne General Crna
- Certified Registered Nurse Anesthetist
- Waynesboro, MS
- NPI 1093930638
-
dba Wayne General Hospitalist
- Hospitalist Physician
- Waynesboro, MS
- NPI 1699589143
-
dba Wayne General ER Physicians
- Emergency Medicine Physician
- Waynesboro, MS
- NPI 1972728590
-
dba Cardiology Associates
- Cardiovascular Disease Physician
- Mobile, AL
- NPI 1689623076
-
dba Methodist Rehab Center
- Physical Medicine & Rehabilitation Physician
- Jackson, MS
- NPI 1790711273
-
dba Methodist Rehab Ceter
- Clinical Neuropsychologist
- Jackson, MS
- NPI 1285772293
Cardiovascular Disease
-
- Internal Medicine Physician
- Jackson, MS
- NPI 1609984574
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Jackson, MS
- NPI 1154317527
-
dba UMMC Greenwood Hospital
- General Acute Care Hospital
- Greenwood, MS
- NPI 1699714717
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601942400000",
"number": "1790714954",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 N STATE ST",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5678",
"fax_number": "601-984-5638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 N STATE STREET",
"address_2": "CARDIOLOGY",
"city": "JACKSON",
"state": "MS",
"postal_code": "392164500",
"telephone_number": "601-984-5678",
"fax_number": "601-984-5638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ASHLEY",
"first_name": "KELLAN",
"middle_name": "E",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-01",
"last_updated": "2020-10-06",
"certification_date": "2020-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "OH",
"license": "57.011859",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "MS",
"license": "18726",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "AL",
"license": "33296",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "AL",
"license": "33296",
"primary": false
},
{
"code": "207RI0011X",
"taxonomy_group": "",
"desc": "Internal Medicine, Interventional Cardiology",
"state": "MS",
"license": "18726",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "130850",
"state": "AL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P01233203",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "04034504",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jackson, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.