Individual provider Active NPI

Pauline Ameletse

  • Registered Nurse
  • Ooltewah, TN
National Provider Identifier
1992619779
Registry record updated Sep 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
268974 Issued in TN
Practice address
8622 Tradewind Cir Apt 204
Ooltewah, TN 37363-2918
Phone
(651) 246-2856
NPI assigned
Sep 30, 2026
Last updated
Sep 30, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 30, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 268974 TN Primary

Addresses

Primary practice location

8622 Tradewind Cir Apt 204
Ooltewah, TN 37363-2918

Mailing address

8622 Tradewind Cir Apt 204
Ooltewah, TN 37363-2918
Phone (651) 246-2856

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
268974TNMDRegistered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1790726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790726400000",
    "number": "1992619779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8622 TRADEWIND CIR APT 204",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632918",
            "telephone_number": "651-246-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8622 TRADEWIND CIR APT 204",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373632918",
            "telephone_number": "651-246-2856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AMELETSE",
        "first_name": "PAULINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-30",
        "last_updated": "2026-09-30",
        "certification_date": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "268974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ooltewah, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2026; 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.