Individual provider Active NPI

Ashley Danielle Gross

  • Family Medicine Physician
  • Blytheville, AR
National Provider Identifier
1881269660
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
215079 Issued in AR
Practice address
5027A NCR 1015
Blytheville, AR 72315
Phone
(870) 824-6538
Fax
(870) 824-6545
NPI assigned
May 24, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 215079 AR Primary

Addresses

Primary practice location

5027A NCR 1015
Blytheville, AR 72315

Mailing address

5027A NCR 1015
Blytheville, AR 72315-5803
Phone (870) 824-6538

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20210709000733 AR Practitioner - Nurse Practitioner 4880096122 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
215079ARMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Pain and Regenerative Medicine PC CurrentSince Sep 6, 2022 Accepting new patients

Locations

3922 E Main St
Blytheville, AR 72315
Phone (870) 228-9780

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": "1621814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1881269660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5027A NCR 1015",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "723155803",
            "telephone_number": "870-824-6538",
            "fax_number": "870-824-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5027A NCR 1015",
            "city": "BLYTHEVILLE",
            "state": "AR",
            "postal_code": "72315",
            "telephone_number": "870-824-6538",
            "fax_number": "870-824-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSS",
        "first_name": "ASHLEY",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-24",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AR",
            "license": "215079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blytheville, AR

Sources for this page

Verify at the official NPI Registry.