Individual provider Active NPI

Ashley Lynne Pribble, DNP

  • Gerontology Nurse Practitioner
  • Peoria, IL
National Provider Identifier
1851016745
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
209.025374 Issued in IL
Practice address
200 E Pennsylvania Ave
Peoria, IL 61603-3089
Phone
(309) 624-4000
Fax
(309) 308-0223
NPI assigned
Oct 4, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Nurse Practitioner 363LG0600X 29852 SC
Gerontology Nurse Practitioner 363LG0600X 209.025374 IL Primary

Addresses

Primary practice location

200 E Pennsylvania Ave
Peoria, IL 61603-3089

Mailing address

137 Langham CT
Morton, IL 61550-9542

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, SC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20240425002756 WA Practitioner - Nurse Practitioner 6901273424 Reassigns benefits to 1 organization
I20250606000028 SC Practitioner - Nurse Practitioner 6901273424 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
209.025374ILMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
CH Specialty Services SC LLC CurrentSince Jun 10, 2025 Accepting new patients
Post Acute Medical PLLC CurrentSince Mar 12, 2024 Accepting new patients
Curana Health of South Carolina PC CurrentSince Jun 10, 2025 Accepting new patients

Locations

400 E Rivulon Blvd
Ste 103
Gilbert, AZ 85297

5750 Johnston St
Ste 205
Lafayette, LA 70503
Phone (337) 580-3330

4000 Faber Place Dr
Ste 300
North Charleston, SC 29405
Phone (704) 956-3062

2375 Baker Hospital Blvd
North Charleston, SC 29405
Phone (843) 744-2750

6650 Rivers Ave
North Charleston, SC 29406
Phone (843) 260-5361

255 Midland Pkwy
Summerville, SC 29485
Phone (843) 821-5005

414 17th St SE
Auburn, WA 98002
Phone (253) 320-0748

6025 N Assembly St
Spokane, WA 99205
Phone (509) 326-8282

6220 S Alaska St
Tacoma, WA 98408
Phone (253) 473-2273

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749513600000",
    "number": "1851016745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 LANGHAM CT",
            "city": "MORTON",
            "state": "IL",
            "postal_code": "615509542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E PENNSYLVANIA AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616033089",
            "telephone_number": "309-624-4000",
            "fax_number": "309-308-0223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRIBBLE",
        "first_name": "ASHLEY",
        "middle_name": "LYNNE",
        "name_prefix": "Miss",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-04",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "29852",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "IL",
            "license": "209.025374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.