Basic Information
| Provider Information | |||||||||
| NPI: | 1538444336 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SARVIS | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | TAYLOR | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 360 | ||||||||
| Address2: | |||||||||
| City: | SYLVA | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287790360 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8883396065 | ||||||||
| FaxNumber: | 8285384441 | ||||||||
| Practice Location | |||||||||
| Address1: | 10616 METROMONT PKWY UNIT 210 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282697656 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8286939199 | ||||||||
| FaxNumber: | 8286922487 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/12/2011 | ||||||||
| LastUpdateDate: | 04/21/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/21/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 17606 | SC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 5012090 | NC | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363L00000X | 5012090 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
ID Information
| ID | Type | State | Issuer | Description | 3387090 | 01 | SC | UNITED HEALTHCARE | OTHER | 9719991 | 01 | SC | AETNA | OTHER | P01004523 | 01 | SC | RAILROAD MEDICARE | OTHER | NP1928 | 05 | SC | MEDICAID | 80036242 | 01 | SC | SELECT HEALTH | OTHER | NN9619A | 01 | NC | MEDICARE PTAN | OTHER | P01585589 | 01 | SC | RR MEDICARE | OTHER | 30108093 | 01 | SC | SELECT HEALTH | OTHER |