ASHLEY KOONG (APRN, PMHNP-BC) – Psychiatric/Mental Health Nurse Practitioner, NPI 1023801032

ASHLEY KOONG (APRN, PMHNP-BC) is a healthcare provider. based in Big canoe, Georgia. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN, PMHNP-BC. They hold a License No. GAA-NP003350 (GA). The NPI Number for ASHLEY KOONG (APRN, PMHNP-BC) is 1023801032

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
ASHLEY KOONG (APRN, PMHNP-BC)
NPI
1023801032
Phone
(808) 777-9460
Address
12034 BIG CANOE
Enumeration Date
23 May 2025
Last Update Date
1 December 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8885153834
Graduation Year
2025 (1 year ago)
PAC ID
5092175737
Group Practice PAC ID
7416254990
Professional Enrollment ID
I20250714000118
Address ID
GA300972456JO11340DRXX301
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness85
Years active:1State licenses:2Digital endpointsOther names

887 NURSE PRACTITIONER in HI

Provider Addresses for ASHLEY KOONG (APRN, PMHNP-BC)

  • 12034 BIG CANOE

    BIG CANOE, GA 301435154

    Phone: (808) 777-9460

    Fax: (808) 217-9174

    Type: Mailing

  • 928 NUUANU AVE # 1

    HONOLULU, HI 968175190

    Phone: (808) 777-9460

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-12-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250714000118INurse PractitionerGATBD
I20251215002822INurse PractitionerHITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30143)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416254990View full group profile
NameSpecialtyState
Mental Health CounselorGA
Nurse PractitionerCA
Nurse PractitionerGA
Nurse PractitionerGA
Nurse PractitionerGA
Marriage And Family TherapistGA
Mental Health CounselorGA
-GA
-TN
Undefined Non Physician Type (Specify)SC

Reviews

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Frequently asked questions

How is ASHLEY KOONG (APRN, PMHNP-BC) identified in CMS data?
CMS-hosted NPPES data lists ASHLEY KOONG (APRN, PMHNP-BC) with NPI 1023801032.
Does CMS list ASHLEY KOONG (APRN, PMHNP-BC) as active?
Yes — ASHLEY KOONG (APRN, PMHNP-BC) is active in the NPI listing used on this page.
What taxonomy line describes ASHLEY KOONG (APRN, PMHNP-BC)?
For research purposes, treat ASHLEY KOONG (APRN, PMHNP-BC) as Psychiatric/Mental Health Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for ASHLEY KOONG (APRN, PMHNP-BC)?
ASHLEY KOONG (APRN, PMHNP-BC)'s geographic hint is Big Canoe, Georgia in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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