NPIMap

Individual provider Active NPI

Alexandra Rose Mudd, PA-C

  • Physician Assistant
  • Knoxville, TN
National Provider Identifier
1548737331
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
4685 Issued in TN
Practice address
1600 Accelerator Way
Knoxville, TN 37920-3078
Phone
(865) 546-2663
Fax
(865) 546-9047
NPI assigned
Oct 30, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2416 KY
Surgical Physician Assistant 363AS0400X 4685 TN
Physician Assistant 363A00000X 4685 TN Primary

Addresses

Primary practice location

1600 Accelerator Way
Knoxville, TN 37920-3078

Mailing address

1600 Accelerator Way
Knoxville, TN 37920-3078
Phone (865) 546-2663

Other practice location 1

1926 Alcoa Hwy Ste 210
Knoxville, TN 37920-1543
Phone (865) 546-2663

Other practice location 2

101 Stonecrest Rd Ste 106
Shelbyville, KY 40065-8169
Phone (502) 647-7708

Other identifiers 1

IdentifierTypeStateIssuer
7100612140MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181112000892 KY Practitioner - Physician Assistant 0143574103 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1868 W Hebron LN
Shepherdsville, KY 40165-7481
Phone (502) 955-3312

1903 W Hebron LN
Shepherdsville, KY 40165-7425
Phone (502) 852-5341

201 Abraham Flexner Way
Louisville, KY 40202-3841

571 S Floyd St
Louisville, KY 40202-3818
Phone (502) 629-2398

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.96 of 100Reported as group
Quality
56.12
Promoting interoperability
100
Improvement activities
40
Cost
73.73

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2416KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Komg-Louisville Region Inc. CurrentSince Jan 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Nov 1, 2019 Accepting new patients
Orthotennessee, PC Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

5100 Outer Loop
Louisville, KY 40219
Phone (502) 968-6226

100 E Liberty St
Ste 800
Louisville, KY 40202
Phone (502) 540-3339

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

130 Stonecrest Rd
Ste 106
Shelbyville, KY 40065
Phone (502) 633-6062

101 Stonecrest Rd
Ste 2
Shelbyville, KY 40065
Phone (502) 647-0311

Interoperability endpoints

  • Direct secure messaging: alexandra.mudd.p1@direct.orthotn.nextgenshare.com
  • Direct secure messaging: amudd13888@uoflhealth-dm.org

Organizations & group practices 5

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

Hospital & facility affiliations 22

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1540857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1548737331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ACCELERATOR WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203078",
            "telephone_number": "865-546-2663",
            "fax_number": "865-546-9047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ACCELERATOR WAY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203078",
            "telephone_number": "865-546-2663",
            "fax_number": "865-546-9047"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1926 Alcoa Hwy Ste 210",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379201543",
            "country_code": "US",
            "telephone_number": "865-546-2663",
            "fax_number": "865-546-9047",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Stonecrest Rd Ste 106",
            "address_purpose": "LOCATION",
            "city": "Shelbyville",
            "state": "KY",
            "postal_code": "400658169",
            "country_code": "US",
            "telephone_number": "502-647-7708",
            "fax_number": "502-647-7747",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MUDD",
        "first_name": "ALEXANDRA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-30",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA2416",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TN",
            "license": "4685",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "4685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100612140",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.