Provider Demographics
NPI:1811916612
Name:GREENE, ASHLEY Y (PA-C)
Entity type:Individual
Prefix:MR
First Name:ASHLEY
Middle Name:Y
Last Name:GREENE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9125 CROSS PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4563
Mailing Address - Country:US
Mailing Address - Phone:865-632-5900
Mailing Address - Fax:865-374-2129
Practice Address - Street 1:9125 CROSS PARK DR STE 200
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4563
Practice Address - Country:US
Practice Address - Phone:865-632-5900
Practice Address - Fax:865-374-2129
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI21961-875363A00000X
SC5688363A00000X
ARPA-1113363A00000X
IN10000417A363AS0400X
TN6031363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC7374PAMedicaid
970012674OtherRAILROAD MEDICARE
TNQ093986Medicaid
000000374069OtherBCBS PIN
P03695Medicare UPIN
IN558430063Medicare PIN