Individual provider Active NPI

Ashley Lauren Fedusenko

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Chattanooga, TN
National Provider Identifier
1861846800
Registry record updated Oct 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
License
60391 Issued in TN
Practice address
979 E 3Rd St Ste A540A550
Chattanooga, TN 37403-2136
Phone
(423) 778-2867
Fax
(423) 778-8182
NPI assigned
Apr 15, 2016
Last updated
Oct 27, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 86562 GA
Family Medicine Physician 207Q00000X 60391 TN
Hospice and Palliative Medicine (Family Medicine) Physician 207QH0002X 60391 TN Primary

Addresses

Primary practice location

979 E 3Rd St Ste A540A550
Chattanooga, TN 37403-2136

Mailing address

7887 Eden CT
Chattanooga, TN 37421-4865
Phone (423) 785-7637

Other practice location 1

677 Church St NE
Marietta, GA 30060-1101
Phone (770) 793-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210901004240 TN Practitioner - Hospice/Palliative CarePractitioner - Family Practice 0648557017 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hospice/Palliative CareAlso: Family Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Erlanger HealthGroup PAC ID 1153780226, 504 clinicians

Practice addresses (Care Compare)

102 Central Ave
Chattanooga, TN 37403-1503
Phone (423) 266-3636

1755 Gunbarrel Rd
Chattanooga, TN 37421-3185

2600 Taft Hwy
Suite 100
Signal Mountain, TN 37377-2777
Phone (423) 778-9434

979 E 3Rd St
Chattanooga, TN 37403-2136

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100Reported as apm
Quality
80.38
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chattanooga Hamilton County Hospital Authority CurrentSince Sep 20, 2021 Accepting new patients
Chattanooga Hamilton County Hospital Authority Family Medicine CurrentSince Sep 20, 2021 Accepting new patients
Erlanger Health Family Medicine CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health CurrentSince Jul 1, 2023 Accepting new patients
Erlanger Health Family Medicine Past Accepting new patients

Locations

102 Central Ave
Chattanooga, TN 37403
Phone (423) 266-3636

1635 Gunbarrel Rd
Ste 300
Chattanooga, TN 37421
Phone (423) 778-8864

1755 Gunbarrel Rd
Ste 300
Chattanooga, TN 37421
Phone (423) 778-4830

975 E 3rd St
Chattanooga, TN 37403
Phone (423) 266-1499

979 E 3rd St
Ste A245
Chattanooga, TN 37403
Phone (423) 778-2867

2600 Taft Hwy
Ste 100
Signal Mtn, TN 37377
Phone (423) 778-9434

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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": "1460678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635292800000",
    "number": "1861846800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7887 EDEN CT",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214865",
            "telephone_number": "423-785-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "979 E 3RD ST STE A540A550",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374032136",
            "telephone_number": "423-778-2867",
            "fax_number": "423-778-8182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "677 Church St NE",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300601101",
            "country_code": "US",
            "telephone_number": "770-793-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEDUSENKO",
        "first_name": "ASHLEY",
        "middle_name": "LAUREN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-15",
        "last_updated": "2021-10-27",
        "certification_date": "2021-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "86562",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "60391",
            "primary": false
        },
        {
            "code": "207QH0002X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": "TN",
            "license": "60391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.