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MOUNTAIN MEDICAL SERVICES PLLC
NPI 1053610717
Nurse Practitioner - Family in Kodak, TN

Active since March 21, 2011CLIA 44D2023831 · Waiver
2946 WINFIELD DUNN PKWY STE 107, KODAK, TN 37764(865) 933-9950(865) 465-3937 Get Directions Write a Review

NPPES record last updated: June 9, 2015. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Mountain Medical Services Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MOUNTAIN MEDICAL SERVICES PLLC (NPI 1053610717) is a healthcare organization registered as a family in Kodak, Tennessee and active in the NPI registry since March 2011. The organization holds a CLIA Waiver certificate valid through May 3, 2027 and lists Roger Dale Barnes, Doctor, as its authorized official.

NPPES Registry Identity

NPI1053610717
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameMOUNTAIN MEDICAL SERVICES PLLC
Location Address2946 WINFIELD DUNN PKWY STE 107Kodak, TN 37764-4306
Mailing Address2946 Winfield Dunn Pkwy Ste 107Kodak, TN 37764-4306 · (865) 933-9950
Phone(865) 933-9950
Fax(865) 465-3937
Organization SubpartNo
Authorized OfficialRoger Dale BarnesDoctor · (865) 933-9950
Enumeration DateMarch 21, 2011
Last NPPES UpdateJune 9, 2015
✔ NPI 1053610717 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in TN · APN 13355
2946 WINFIELD DUNN PKWY STE 107, Kodak, TN 37764
Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 44D2023831

Mountain Medical Services PLLC · Kodak, TN
Active · expires May 3, 2027
CLIA Number44D2023831
Laboratory TypePhysician Office
Certificate Effective DateMay 4, 2025
Certificate Expiration DateMay 3, 2027
Laboratory DirectorRoger D. Barnes
Laboratory Phone(865) 933-9950
Laboratory LocationMountain Medical Services PLLC546 Douglas Dam Rd, Kodak, TN 37764
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYCEE NICOLE DIXON FNP-C
Nurse Practitioner (Family)
2946 WINFIELD DUNN PKWY STE 107
KODAK, TN 37764
Sevier County (865) 933-9950
SAMAN PERERA
Nurse Practitioner (Primary Care)
2946 WINFIELD DUNN PKWY STE 107
KODAK, TN 37764
Sevier County (865) 933-9950

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mountain Medical Services PLLC's NPI number?

The NPI number for Mountain Medical Services PLLC is 1053610717. It was assigned to this organization in the NPPES registry on March 21, 2011.

Where is Mountain Medical Services PLLC located?

Mountain Medical Services PLLC is located at 2946 Winfield Dunn Pkwy Ste 107, Kodak, TN 37764. The listed phone number is (865) 933-9950.

What is Mountain Medical Services PLLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Does Mountain Medical Services PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 44D2023831) is associated with this NPI, valid through May 3, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Mountain Medical Services PLLC was last updated on June 9, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.