Healthcare Provider Details

I. General information

NPI: 1619100278
Provider Name (Legal Business Name): ASHLEY MARIE CARROLL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY MARIE PEREYRA

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST STE 463
OLATHE KS
66061-7210
US

IV. Provider business mailing address

2790 CLAY EDWARDS DR STE 625
NORTH KANSAS CITY MO
64116-3278
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 816-455-3990
  • Fax: 816-455-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number20491
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2021023485
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15-02607
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: