Individual provider Active NPI

Denver Moses, NP

  • Primary Care Nurse Practitioner
  • Novi, MI
National Provider Identifier
1003607961
Registry record updated Jan 14, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
40135 Issued in TN
Practice address
41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818
Phone
(248) 660-1220
NPI assigned
May 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 40135 TN Primary

Addresses

Primary practice location

41800 W 11 Mile Rd Ste 109
Novi, MI 48375-1818

Mailing address

404 S Cumberland Ave
La Follette, TN 37766-3736
Phone (423) 494-4485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, TN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250825001138 MI Practitioner - Nurse Practitioner 9032619069 Reassigns benefits to 2 organizations
I20260326003899 TN Practitioner - Nurse Practitioner 9032619069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Theoria MedicalGroup PAC ID 5395098339, 317 clinicians

Practice addresses (Care Compare)

2685 W Maple Rd
Troy, MI 48084-7122
Phone (248) 965-7900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
40135TNMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Complexcare Medical Group Midwest H PLLC CurrentSince Aug 31, 2025 Accepting new patients
Theoria Medical CurrentSince Jun 19, 2025 Accepting new patients

Locations

5655 Clarkston Rd
Clarkston, MI 48348
Phone (810) 623-5216

2567 W Grand Blvd
Detroit, MI 48208
Phone (313) 895-2990

6700 W Outer Dr
Detroit, MI 48235
Phone (313) 836-1700

3139 E Baldwin Rd
Grand Blanc, MI 48439
Phone (810) 445-5300

41800 W 11 Mile Rd
Ste 109
Novi, MI 48375
Phone (833) 578-2763

2685 W Maple Rd
Troy, MI 48084
Phone (248) 262-2357

31830 Ryan Rd
Warren, MI 48092
Phone (586) 795-5862

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768348800000",
    "number": "1003607961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 S CUMBERLAND AVE",
            "city": "LA FOLLETTE",
            "state": "TN",
            "postal_code": "377663736",
            "telephone_number": "423-494-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41800 W 11 MILE RD STE 109",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483751818",
            "telephone_number": "248-660-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "DENVER",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-13",
        "last_updated": "2026-01-14",
        "certification_date": "2026-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TN",
            "license": "40135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Novi, MI

Sources for this page

Verify at the official NPI Registry.