Andrea Moskonas, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

201390804RN Issued in OR

Practice address

601 Whiskey Creek Rd
Wallowa, OR 97885-7129

Phone

(541) 886-3142

NPI assigned

Mar 26, 2019

Last updated

Mar 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

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

• Wallowa Valley Center for Wellness

  • Mental Illness Community Based Residential Treatment Facility
  • Wallowa, OR
  • NPI 1417192972
  NPD (past)

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1013478817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 268",
            "city": "ENTERPRISE",
            "state": "OR",
            "postal_code": "978280268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 WHISKEY CREEK RD",
            "city": "WALLOWA",
            "state": "OR",
            "postal_code": "978857129",
            "telephone_number": "541-886-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSKONAS",
        "first_name": "ANDREA",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "201390804RN",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OREGON STATE BOARD OF NURSING",
            "identifier": "201390804RN",
            "state": "OR"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "andrea.moskonas@gobhi.net",
            "affiliation": "N",
            "endpointDescription": "encrypted email",
            "address_1": "601 Whiskey Creek Rd",
            "city": "Wallowa",
            "state": "OR",
            "country_code": "US",
            "postal_code": "978857129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tarrah Margaret Baker, MS SLPCCC
• James Bryan Barnum, D.M.D.
• Jean Wayne Foster, R.PH.
• Eleanor Hawkins, DEM, LDM, IBCLC
• Hilary Miller, RN
• Martha Spaur
• Anne Tomlinson
• Wallowa County Health Care District (Wallowa Memorial Medical Clinic - Wallowa)
• Wallowa Pharmacy
• Wallowa School District #12

• Registered Nurse in Wallowa, OR
• Providers in Wallowa, OR by specialty
• Registered Nurse in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; 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.