Stephan Michael Moss

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10566698-4405 Issued in UT

Practice address

600 W Hospital Rd
Brigham City, UT 84302-3006

Phone

(435) 734-2041

NPI assigned

Jun 15, 2018

Last updated

Nov 21, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brigham Medical Clinic, Inc.Group PAC ID 8628000809, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Nell J Redfield Memorial Hospital Hospital, Malad City, ID, CCN 131303
• Brigham City Community Hospital Hospital, Brigham City, UT, CCN 460017

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: stephan.moss@999388869427204.direct.elationemr.com

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.

• Brigham Medical Clinic, Inc.

  • Family Medicine Physician
  • Brigham City, UT
  • NPI 1922119528
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brigham City Community Hospital, Inc.

  dba Brigham City Community Hospital

  • General Acute Care Hospital
  • Brigham City, UT
  • NPI 1245282227
  Care Compare affiliation
• Oneida County Hospital

  • Critical Access Hospital
  • Malad, ID
  • NPI 1609826270
  Care Compare affiliation

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

{
    "created_epoch": "1529020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1063906857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 W HOSPITAL RD",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023006",
            "telephone_number": "435-734-2041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W HOSPITAL RD",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023006",
            "telephone_number": "435-734-2041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1545 Canyon View Dr",
            "address_purpose": "LOCATION",
            "city": "Perry",
            "state": "UT",
            "postal_code": "843026713",
            "country_code": "US",
            "telephone_number": "480-773-3969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSS",
        "first_name": "STEPHAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-15",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "10566698-4405",
            "primary": true
        },
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "UT",
            "license": "10566698-3102",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10566698-4405",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sean C Morris
• Chris Mortensen
• Kjersten Celeste Mortensen
• Michael Mortensen
• Neal James Mortensen
• Tyler Scott Moss
• Mountain Top Medical, PLLC
• Mountain View Foot and Ankle Specialists Inc
• Mountainstar Brigham OBGYN, LLC (Brigham Center for Women's Health)
• Mountainstar Canyon Surgical Clinic LLC

• Family Nurse Practitioner in Brigham City, UT
• Providers in Brigham City, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.