Individual provider Active NPI

Ashli Palmer, FNP

  • Family Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1861923302
Registry record updated Mar 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5009409 Issued in NC
Practice address
5110 Park Rd
Suite 1J
Charlotte, NC 28209-3699
Phone
(704) 496-9100
NPI assigned
Mar 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5009409 NC Primary

Addresses

Primary practice location

5110 Park Rd
Suite 1J
Charlotte, NC 28209-3699

Mailing address

5110 Park Rd
Suite 1J
Charlotte, NC 28209-3699
Phone (704) 496-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20170522001838 NC Practitioner - Nurse Practitioner 6901173053 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolina Express ClinicGroup PAC ID 5799910642, 3 clinicians

Practice addresses (Care Compare)

5110 Park Rd
Suite 1J
Charlotte, NC 28209-3735
Phone (704) 572-0154

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5009409NCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Express Clinic CurrentSince Mar 19, 2017 Accepting new patients
Maine Urgent Care, LLC Past Accepting new patients

Locations

5110 Park Rd
Ste 1J
Charlotte, NC 28209
Phone (704) 496-9100

Interoperability endpoints

  • Direct secure messaging: ashil.palmer.1@30433.direct.athenahealth.com

Organizations & group practices 2

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": "1490486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490486400000",
    "number": "1861923302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5110 PARK RD",
            "address_2": "SUITE 1J",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093699",
            "telephone_number": "704-496-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5110 PARK RD",
            "address_2": "SUITE 1J",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282093699",
            "telephone_number": "704-496-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMER",
        "first_name": "ASHLI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-26",
        "last_updated": "2017-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5009409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.