Individual ProviderAshley SelfFamily MedicineAllopathic & Osteopathic PhysiciansPractice Address1601 Owen Dr, Fayetteville, NC 28304-3425(910) 678-0100PECOS EnrollmentBased on the most recent information from CMS, provider Ashley Self is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 5 days ago.Profile DetailsProvider ID1518314269Provider TypeIndividualFull NameSelf, AshleyCredentialD.O.GenderFemaleSole ProprietorNoEnumeration Date5/23/2016Last Updated11/2/2021Contact InformationPractice LocationPractice Address1601 Owen Dr, Fayetteville, NC 28304-3425Phone(910) 678-0100Fax(910) 678-0115Mailing LocationMailing Address1601 Owen Dr, Fayetteville, NC 28304-3425Phone(910) 678-0100Fax(910) 678-0115Provider TaxonomiesCodeDescriptionLicenseCode207Q00000XPrimaryDescriptionFamily MedicineAllopathic & Osteopathic PhysiciansLicense2019-01516North CarolinaCode207P00000XDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicense4003Tennessee