Individual provider Active NPI

Dorothea Marie Moxley, LPN

  • Licensed Practical Nurse
  • Westerville, OH
National Provider Identifier
1003022104
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
113195 Issued in OH
Practice address
39 N Otterbein Ave
Westerville, OH 43081
Phone
(614) 674-3816
NPI assigned
May 15, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 113195 OH Primary

Addresses

Primary practice location

39 N Otterbein Ave
Westerville, OH 43081

Mailing address

39 N Otterbein Ave
Westerville, OH 43081-1707
Phone (614) 674-3816

Other names 1

  • Dorothea Marie Ingram Other name

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
113195OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463529600000",
    "number": "1003022104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 N OTTERBEIN AVE",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "430811707",
            "telephone_number": "614-674-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 N OTTERBEIN AVE",
            "city": "WESTERVILLE",
            "state": "OH",
            "postal_code": "43081",
            "telephone_number": "614-674-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOXLEY",
        "first_name": "DOROTHEA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-15",
        "last_updated": "2016-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "113195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOROTHEA",
            "last_name": "INGRAM",
            "middle_name": "MARIE",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westerville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2016; 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.