Provider Demographics
NPI:1508245002
Name:SMITH, ASHLEY K (AA-C)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:K
Last Name:SMITH
Suffix:
Gender:F
Credentials:AA-C
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:K
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AA-C
Mailing Address - Street 1:8000 E. MAPLEWOOD AVE.
Mailing Address - Street 2:BUILDING 5, SUITE 200
Mailing Address - City:GREENWOOD VILLAGE
Mailing Address - State:CO
Mailing Address - Zip Code:80111-4717
Mailing Address - Country:US
Mailing Address - Phone:303-438-3999
Mailing Address - Fax:720-439-9500
Practice Address - Street 1:12605 E 16TH AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2545
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-29
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COANT.0000059367H00000X
OK20367H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist AssistantGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO527898YKTGMedicare PIN