NPIMap

Individual provider Active NPI

Ashley Nicole Dean-Reaves, NP

  • Family Nurse Practitioner
  • Gulfport, MS
National Provider Identifier
1962950303
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
901636 Issued in MS
Practice address
4502 Old Pass Rd
Gulfport, MS 39501
Phone
(228) 863-9977
Fax
(228) 863-9912
NPI assigned
Sep 14, 2016
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R901636 MS
Family Nurse Practitioner 363LF0000X 901636 MS Primary

Addresses

Primary practice location

4502 Old Pass Rd
Gulfport, MS 39501

Mailing address

4502 Old Pass Rd
Gulfport, MS 39501
Phone (228) 863-9977

Other identifiers 1

IdentifierTypeStateIssuer
01700380MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170919003070 MS Practitioner - Nurse Practitioner 1951675651 Reassigns benefits to 2 organizations

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
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

4577 13TH St
Gulfport, MS 39501-2516
Phone (228) 864-2752

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
901636MSMDFamily Nurse Practitioner
R901636MSMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Mississippi, LLC CurrentSince Dec 18, 2020 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Ochsner Mississippi, LLC CurrentSince Dec 18, 2020 Accepting new patients
Memorial Hospital at Gulfport CurrentSince Dec 31, 2023 Accepting new patients
Ochsner Mississippi, LLC Current Accepting new patients
Memorial Hospital at Gulfport CurrentSince Dec 31, 2023 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients

Locations

149 Drinkwater Rd
Bay St Louis, MS 39520
Phone (228) 467-8600

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

4502 Old Pass Rd
Gulfport, MS 39501
Phone (228) 314-7226

4577 13th St
Gulfport, MS 39501
Phone (228) 864-2752

Interoperability endpoints

  • Direct secure messaging: adean-reaves@direct.mhg.com

Organizations & group practices 8

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 60

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1473811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1962950303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4502 OLD PASS RD",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "39501",
            "telephone_number": "228-863-9977",
            "fax_number": "228-863-9912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEAN-REAVES",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-14",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "R901636",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "901636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01700380",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gulfport, MS

Sources for this page

Verify at the official NPI Registry.