MEDICARE: MRS. ASHLEY MARIE CARROLL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	20491	CA
2	363A00000X	Physician Assistant	2021023485	MO
3	363A00000X	Physician Assistant	15-02607	KS

General Provider Information

NPI Number	:	1619100278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ASHLEY MARIE CARROLL PA-C

Provider Business Mailing Address
First Line	:	2790 CLAY EDWARDS DR STE 625
Second Line	:
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3278
Country	:	US
Telephone Number	:	816-455-3990
Fax Number	:	816-455-5351

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST STE 463
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-7210
Country	:	US
Telephone Number	:	913-588-1227
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2009
Last Update Date	:	12/10/2025

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