Individual provider Active NPI

Ailene Fay Radcliffe, LMT

  • Community Health Worker
  • Oak Ridge, TN
National Provider Identifier
1386889301
Registry record updated Dec 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health WorkerTaxonomy code 172V00000X
License
0000003279 Issued in TN
Practice address
665 Emory Valley Rd
Ste. a
Oak Ridge, TN 37830-7762
Phone
(865) 482-0981
Fax
(865) 482-0959
NPI assigned
Dec 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X 0000003279 TN Primary

Addresses

Primary practice location

665 Emory Valley Rd
Ste. a
Oak Ridge, TN 37830-7762

Mailing address

251 Arrowhead TRL
Kingston, TN 37763-7003
Phone (865) 406-1143

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

State licenses

LicenseStateTypeSpecialty
0000003279TNMDCommunity Health Worker

NPI Registry JSON

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

{
    "created_epoch": "1228348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228348800000",
    "number": "1386889301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 ARROWHEAD TRL",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377637003",
            "telephone_number": "865-406-1143",
            "fax_number": "865-482-0959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 EMORY VALLEY RD",
            "address_2": "STE. A",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307762",
            "telephone_number": "865-482-0981",
            "fax_number": "865-482-0959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADCLIFFE",
        "first_name": "AILENE",
        "middle_name": "FAY",
        "name_prefix": "Mrs.",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-04",
        "last_updated": "2008-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": "TN",
            "license": "0000003279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.