Provider Demographics
NPI:1114211836
Name:ROBINSON, ASHLEY LONG (PT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LONG
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:MICHELLE
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:PO BOX 32569
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37930-2569
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:9430 PARK WEST BLVD
Practice Address - Street 2:STE 235
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4200
Practice Address - Country:US
Practice Address - Phone:865-560-8550
Practice Address - Fax:865-560-8551
Is Sole Proprietor?:No
Enumeration Date:2011-05-31
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8942225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1525243Medicaid
TN0677340001Medicare NSC
TN0677340003Medicare NSC
TN0677340005Medicare NSC
TN1525243Medicaid
TN103I650704Medicare PIN
TN103I650709Medicare PIN
TN0677340004Medicare NSC