Individual provider Active NPI

Ashley Nichole Reid, PA

  • Physician Assistant
  • Port Charlotte, FL
National Provider Identifier
1962752279
Registry record updated May 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PAT9106772 Issued in FL
Practice address
2040 Tamiami TRL
Suite C
Port Charlotte, FL 33948-2178
Phone
(941) 629-4464
Fax
(941) 629-4701
NPI assigned
Sep 13, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PAT9106772 FL Primary

Addresses

Primary practice location

2040 Tamiami TRL
Suite C
Port Charlotte, FL 33948-2178

Mailing address

2040 Tamiami TRL
Suite C
Port Charlotte, FL 33948-2178
Phone (941) 629-4464

Other identifiers 1

IdentifierTypeStateIssuer
007956400MedicaidFL

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
I20121029000132 FL Practitioner - Physician Assistant 1850541806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
ENT and Allergy Associates of Florida, LLCGroup PAC ID 0042292849, 227 clinicians

Practice addresses (Care Compare)

900 NW 13TH St
Suite 206
Boca Raton, FL 33486-2350
Phone (561) 391-3333

Hospital & facility affiliations

  • HCA Florida Fawcett Hospital Hospital, Port Charlotte, FL, CCN 100236
  • Adventhealth Port Charlotte Hospital, Port Charlotte, FL, CCN 100077

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAT9106772FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
ENT and Allergy Associates of Florida, LLC CurrentSince Apr 1, 2026 Accepting new patients
Helgemo & Liou Pediatrics Past Accepting new patients

Locations

6421 Congress Ave
Ste 113
Boca Raton, FL 33487
Phone (561) 338-3267

900 NW 13th St
Ste 206
Boca Raton, FL 33486
Phone (561) 338-3267

2300 Loveland Blvd
Unit 1
Pt Charlotte, FL 33980
Phone (941) 743-6866

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

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.

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": "1347494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399939200000",
    "number": "1962752279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2040 TAMIAMI TRL",
            "address_2": "SUITE C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482178",
            "telephone_number": "941-629-4464",
            "fax_number": "941-629-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 TAMIAMI TRL",
            "address_2": "SUITE C",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339482178",
            "telephone_number": "941-629-4464",
            "fax_number": "941-629-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REID",
        "first_name": "ASHLEY",
        "middle_name": "NICHOLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-13",
        "last_updated": "2014-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PAT9106772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007956400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

Verify at the official NPI Registry.