Individual provider Active NPI

Ashlyn Noel Muntin, FNP

  • Family Nurse Practitioner
  • Gaylord, MI
National Provider Identifier
1972317592
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704353097 Issued in MI
Practice address
829 N Center Ave Ste 140
Gaylord, MI 49735-1598
Phone
(989) 731-7870
NPI assigned
Feb 4, 2025
Last updated
Mar 27, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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 4704353097 MI Primary

Addresses

Primary practice location

829 N Center Ave Ste 140
Gaylord, MI 49735-1598

Mailing address

10220 Shawnee TRL
Gaylord, MI 49735-8848
Phone (305) 240-9970

Other names 1

  • Miss Ashlyn Noel Cockrell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250910002450 MI Practitioner - Nurse Practitioner 2365945037 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1996 Walden
Otsego County Memorial Hospital
Gaylord, MI 49735
Phone 51773141111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4704353097MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Healthcare Otsego Memorial Hospital Current Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jul 7, 2025 Accepting new patients
Munson Healthcare Otsego Memorial Hospital CurrentSince Jul 7, 2025 Accepting new patients

Locations

829 N Center Ave
Gaylord, MI 49735
Phone (989) 731-2100

829 N Center Ave
Ste 140
Gaylord, MI 49735
Phone (989) 731-7860

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

Organizations & group practices 3

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 3

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": "1738627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1972317592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10220 SHAWNEE TRL",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497358848",
            "telephone_number": "305-240-9970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "829 N CENTER AVE STE 140",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351598",
            "telephone_number": "989-731-7870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUNTIN",
        "first_name": "ASHLYN",
        "middle_name": "NOEL",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-04",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704353097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLYN",
            "last_name": "COCKRELL",
            "middle_name": "NOEL",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gaylord, MI

Sources for this page

Verify at the official NPI Registry.