Deidre Ashley

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

785 Issued in WY

Practice address

640 E Broadway Ave
Jackson, WY 83001-8642

Phone

(307) 733-2046

Fax

(307) 733-6289

NPI assigned

Sep 8, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Mental Health & Recovery Services of Jackson Hole

  • Case Manager/Care Coordinator
  • Jackson, WY
  • NPI 1548137508
  NPD

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

{
    "created_epoch": "1252368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582675200000",
    "number": "1992038079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 EAST KELLY",
            "address_2": "PO BOX 7331",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "83002",
            "telephone_number": "307-690-5627"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "640 E BROADWAY AVE",
            "city": "JACKSON",
            "state": "WY",
            "postal_code": "830018642",
            "telephone_number": "307-733-2046",
            "fax_number": "307-733-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHLEY",
        "first_name": "DEIDRE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-09-08",
        "last_updated": "2020-02-26",
        "certification_date": "2020-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WY",
            "license": "785",
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "WY",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anesthesia Services of Jacksonhole, P.C.
• Angus Goetz DO PC
• Cynthia L Archer, MD
• Allison Odato Armitage
• Stephen Louis Arnold, DPT
• Ivy E. Assenberg, LPC
• Megan Rose Avery, PA-C
• Olga Baeva Johnson, FNP-C
• Pamela E Bailey, O.T.R.
• Paul Bailey

• All providers in Jackson, WY
• Clinical Social Worker in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.