CMS-1500 Box 24J / 33a • NPI
1669048294
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LF0000X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family
Box 32 Service Location & ZIP+4
130 W RAVINE RD, KINGSPORT, TN, 37660-3837
✓ 9-Digit EDI 837 ZIP+4 (37660-3837)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1669048294 (MIRANDA N ALLEY) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Medicare Part B
✓ Eligible
DMEPOS Ordering
✓ Eligible
Home Health (HHA)
✓ Eligible
Power Mobility
✓ Eligible
Hospice Referring
No
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1669048294 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | MIRANDA N ALLEY |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family NUCC Code: 363LF0000X (Nurse Practitioner, Family) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 130 W RAVINE RD, KINGSPORT, TN, 37660-3837 |
| Practice Telephone / Fax | Tel: (423) 224-4000 |
| Administrative Mailing Address | 1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN, 37604-2192 |
| Enumeration & Last Sync | Enumerated: 2021-06-03 | CMS Record Updated: 2026-03-06 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LF0000X)
What Does Taxonomy Code 363LF0000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LF0000X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (MIRANDA N ALLEY)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LF0000X — Nurse Practitioner, FamilyPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Family | State: TN | License: 29447 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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