Individual provider Active NPI

Alexis M Mosvold

  • Contractor
  • Louisville, KY
National Provider Identifier
1679756456
Registry record updated Dec 14, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
License
KY-0480 Issued in KY
Practice address
409 Marquette Dr
Louisville, KY 40222-4719
Phone
(502) 296-5009
NPI assigned
Dec 14, 2007
Last updated
Dec 14, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 14, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X KY-0480 KY Primary

Addresses

Primary practice location

409 Marquette Dr
Louisville, KY 40222-4719

Mailing address

409 Marquette Dr
Louisville, KY 40222-4719
Phone (502) 296-5009

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
KY-0480KYMDContractor

NPI Registry JSON

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

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197590400000",
    "number": "1679756456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 MARQUETTE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224719",
            "telephone_number": "502-296-5009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 MARQUETTE DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402224719",
            "telephone_number": "502-296-5009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSVOLD",
        "first_name": "ALEXIS",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "KY",
            "license": "KY-0480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; 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.