Active NPI
Kelly E Moens, CRNA
- Certified Registered Nurse Anesthetist
- Spokane Valley, WA
National Provider Identifier
1013025501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- AP30001703
- Practice address
- 12606 E Mission Ave
Spokane Valley, WA 99216-3421 - Phone
- (509) 838-6709
- Fax
- (509) 835-4058
- NPI assigned
- Aug 26, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | AP30001703 | WA | Primary |
Addresses
Primary practice location
12606 E Mission Ave
Spokane Valley, WA 99216-3421
Mailing address
12606 E Mission Ave
Spokane Valley, WA 99216-3421
Phone (509) 838-6709
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004376000 | Medicaid | ID | |
| 244046 | Other | WA | DEPT OF LABOR AND INDUSTRIES |
| 9647041 | Medicaid | WA |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wa Spok DH Crna LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
| Wa Spok VH Crna LLC | Nurse Anesthetist, Certified Registered | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Certified Registered Nurse Anesthetist
- Spokane, WA
- NPI 1366692766
Nurse Anesthetist, Certified Registered
-
- Certified Registered Nurse Anesthetist
- Spokane Valley, WA
- NPI 1285884585
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252713600000",
"number": "1013025501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12606 E MISSION AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992163421",
"telephone_number": "509-838-6709",
"fax_number": "509-835-4058"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12606 E MISSION AVE",
"city": "SPOKANE VALLEY",
"state": "WA",
"postal_code": "992163421",
"telephone_number": "509-838-6709",
"fax_number": "509-835-4058"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOENS",
"first_name": "KELLY",
"middle_name": "E",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-26",
"last_updated": "2009-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "WA",
"license": "AP30001703",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004376000",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF LABOR AND INDUSTRIES",
"identifier": "244046",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9647041",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spokane Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.