NPIMap

Individual provider Active NPI

Kirk D Ashburn II, A.R.N.P.

  • Nurse Practitioner
  • Evansville, IN
National Provider Identifier
1790782845
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
71001760A Issued in IN
Practice address
1212 Professional Blvd Ste B
Evansville, IN 47714-8002
Phone
(812) 401-9030
Fax
(812) 401-9033
NPI assigned
Jul 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 71001760A IN
Nurse Practitioner 363L00000X 71001760A IN Primary

Addresses

Primary practice location

1212 Professional Blvd Ste B
Evansville, IN 47714-8002

Mailing address

1212 Professional Blvd Ste B
Evansville, IN 47714-8002
Phone (812) 401-9030

Other identifiers 3

IdentifierTypeStateIssuer
200207810MedicaidIN
000000387509OtherINANTHEM PIN
P00333134OtherINRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231109001712 IL Practitioner - Nurse Practitioner 9436055472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wabash General Hospital District 77 clinicians

Practice addresses (Care Compare)

11362 Country Club Rd
Lawrenceville, IL 62439-4325
Phone (618) 707-4360

1418 College Dr
Mount Carmel, IL 62863-2638
Phone (618) 262-8621

1527 College Dr
Mount Carmel, IL 62863-2615
Phone (618) 263-6400

Hospital & facility affiliations

  • Wabash General Hospital 1 Hospital, Mount Carmel, IL, CCN 141327
  • Fairfield Memorial Hospital 1 Hospital, Fairfield, IL, CCN 141311
  • Clay County Hospital Hospital, Flora, IL, CCN 141351
  • Deaconess Hospital Inc Hospital, Evansville, IN, CCN 150082
  • Ferrell Hospital Community Foundations Hospital, Eldorado, IL, CCN 141324

Merit-based Incentive Payment System (MIPS)

Final score
64.72 of 100Reported as group
Quality
65.5
Promoting interoperability
100
Improvement activities
40
Cost
10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71001760AINMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wabash General Hospital District CurrentSince Oct 19, 2023 Accepting new patients
Wabash General Hospital District Current Accepting new patients
Wabash General Hospital District Current Accepting new patients
Wabash General Hospital District CurrentSince Oct 19, 2023 Accepting new patients
Henderson Orthopaedic Medical Group, PSC Past Accepting new patients

Locations

929 Stacey Burk Dr
Flora, IL 62839

1525 College Dr
Mount Carmel, IL 62863
Phone (618) 263-6343

1418 College Dr
Mount Carmel, IL 62863
Phone (618) 262-8621

504 Micah Dr
Olney, IL 62450
Phone (618) 395-4306

Interoperability endpoints

  • Direct secure messaging: 07ashk@tsos.srs-direct.com

Organizations & group practices 11

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 12

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": "1120521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790782845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 PROFESSIONAL BLVD STE B",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148002",
            "telephone_number": "812-401-9030",
            "fax_number": "812-401-9033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 PROFESSIONAL BLVD STE B",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477148002",
            "telephone_number": "812-401-9030",
            "fax_number": "812-401-9033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHBURN",
        "first_name": "KIRK",
        "middle_name": "D",
        "name_suffix": "II",
        "credential": "A.R.N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "71001760A",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IN",
            "license": "71001760A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200207810",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000387509",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00333134",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Evansville, IN

Sources for this page

Verify at the official NPI Registry.