Justin Robert Moe

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

License

R-2096708 Issued in MN

Practice address

13355 George Weber Dr Ste B
Rogers, MN 55374-4864

Phone

(612) 554-0740

Fax

(612) 554-0740

NPI assigned

Feb 12, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Life Made Easy Healthcare L.L.C

  • Home Health Registered Nurse
  • Rogers, MN
  • NPI 1891294203
  NPD (past) Authorized official

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

{
    "created_epoch": "1518393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1063911469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13355 GEORGE WEBER DR STE B",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744864",
            "telephone_number": "612-554-0740",
            "fax_number": "612-278-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13355 GEORGE WEBER DR STE B",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553744864",
            "telephone_number": "612-554-0740",
            "fax_number": "612-554-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOE",
        "first_name": "JUSTIN",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Home Health",
            "state": "MN",
            "license": "R-2096708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Midwest Healthcare Groups PLLC
• Midwest Healthcare Groups PLLC
• Cyrenia Miller
• Jaime Koren Miller, NP
• Mind Sparks L. L. C.
• Hafsa Kadid Mohamed
• Maryam Oluwadamilola Mohammed
• Monarch Counseling Collaborative PA
• Tiffany Moriarity, D.P.T.
• Jamie Mosley, MS, LPC

• Home Health Registered Nurse in Rogers, MN
• Providers in Rogers, MN by specialty
• Home Health Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; 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.