Mark Allen Kneisley

Primary specialty

Emergency Registered NurseTaxonomy code 163WE0003X

License

RN-83310 Issued in NM

Practice address

#3 Rougemont LN
Pecos, NM 87552

Phone

(505) 470-0244

NPI assigned

Aug 5, 2022

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1730816083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "HC 74 BOX 875",
            "city": "PECOS",
            "state": "NM",
            "postal_code": "875529515",
            "telephone_number": "505-470-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#3 ROUGEMONT LN",
            "city": "PECOS",
            "state": "NM",
            "postal_code": "87552",
            "telephone_number": "505-470-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNEISLEY",
        "first_name": "MARK",
        "middle_name": "ALLEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "NM",
            "license": "RN-83310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathon Karl Frederiksen, RDH
• Jason Hayes, CNP
• Amy Hood
• Ariel Hubbard-Cordero, LMSW
• Dianna Virginia Jaramillo, CPSW
• Lilia Lopez de Varela, CCHW
• Susan Upton Lovro
• Brigette K Lucero, RN
• Virginia McNally, LPCC, LADAC
• Pamela Ortiz, RN

• Emergency Registered Nurse in Pecos, NM
• Providers in Pecos, NM by specialty
• Emergency Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.

Verify at the official NPI Registry.