Active NPI
Ordalis Alfaro Mountain, RN
- Registered Nurse
- Knoxville, TN
National Provider Identifier
1053917252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 0000236814
- Practice address
- 1819 Northwood Dr
Knoxville, TN 37923-1306 - Phone
- (863) 738-8982
- NPI assigned
- Dec 11, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0000236814 | TN | Primary |
Addresses
Primary practice location
1819 Northwood Dr
Knoxville, TN 37923-1306
Mailing address
1819 Northwood Dr
Knoxville, TN 37923-1306
Phone (863) 738-8982
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0000236814 | TN | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1053917252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1819 NORTHWOOD DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379231306",
"telephone_number": "863-738-8982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1819 NORTHWOOD DR",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379231306",
"telephone_number": "863-738-8982"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUNTAIN",
"first_name": "ORDALIS",
"middle_name": "ALFARO",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-11",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "TN",
"license": "0000236814",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Knoxville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.