Individual provider Active NPI

Ronald C Mahlo, NP-C

  • Family Nurse Practitioner
  • Cleveland, TN
National Provider Identifier
1356456149
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000012156 Issued in TN
Practice address
2390 N Ocoee St
Cleveland, TN 37311-3850
Phone
(423) 339-0300
Fax
(423) 709-0543
NPI assigned
Aug 20, 2006
Last updated
Jun 10, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APN0000012156 TN Primary

Addresses

Primary practice location

2390 N Ocoee St
Cleveland, TN 37311-3850

Mailing address

PO Box 440100
Nashville, TN 37244-0100
Phone (423) 339-0300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061121000047 TN Practitioner - Nurse Practitioner 5890792907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0000012156TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Physician First PC CurrentSince May 2, 2019 Accepting new patients
Healthforce Corporation Past Accepting new patients
Tennessee Cancer Specialists PLLC Past Accepting new patients
Tennessee Cancer Specialists PLLC Past Accepting new patients

Locations

2725 Keith St NW
Cleveland, TN 37312
Phone (423) 476-3330

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433894400000",
    "number": "1356456149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 440100",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372440100",
            "telephone_number": "423-339-0300",
            "fax_number": "423-472-5687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 N OCOEE ST",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113850",
            "telephone_number": "423-339-0300",
            "fax_number": "423-709-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHLO",
        "first_name": "RONALD",
        "middle_name": "C",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2015-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000012156",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.