Individual provider Active NPI

Ashley Lentine Sapp, PA-C

  • Medical Physician Assistant
  • Orlando, FL
National Provider Identifier
1861704512
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PAT 9105504 Issued in FL
Practice address
7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone
(407) 352-9717
Fax
(407) 354-5425
NPI assigned
Jul 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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 PAT 9105504 FL Primary

Addresses

Primary practice location

7400 Docs Grove Cir
Orlando, FL 32819-8010

Mailing address

7400 Docs Grove Cir
Orlando, FL 32819-8010
Phone (407) 352-9717

Other identifiers 1

IdentifierTypeStateIssuer
PA9105504OtherFLFLORIDA LICENSE BOARD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20101130000044 FL Practitioner - Physician Assistant 4789870007

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT 9105504FLMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Orlando Family Medicine,P.L. CurrentSince Apr 3, 2018 Accepting new patients

Locations

7400 Docs Grove Cir
Orlando, FL 32819
Phone (407) 352-9717

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1861704512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-352-9717",
            "fax_number": "407-354-5425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 DOCS GROVE CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328198010",
            "telephone_number": "407-352-9717",
            "fax_number": "407-354-5425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAPP",
        "first_name": "ASHLEY",
        "middle_name": "LENTINE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-10",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "FL",
            "license": "PAT 9105504",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA LICENSE BOARD",
            "identifier": "PA9105504",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.