Individual provider Active NPI

Moses Mugo

  • Licensed Practical Nurse
  • Lowell, MA
National Provider Identifier
1073198594
Registry record updated Mar 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LN66802 Issued in MA
Practice address
41 New Caster Dr
Lowell, MA 01854-1221
Phone
(978) 954-8246
Fax
(978) 454-3135
NPI assigned
Mar 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LN66802 MA Primary

Addresses

Primary practice location

41 New Caster Dr
Lowell, MA 01854-1221

Mailing address

41 New Caster Dr
Lowell, MA 01854-1221
Phone (978) 954-8246

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LN66802MAMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1615852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1073198594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 NEW CASTER DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018541221",
            "telephone_number": "978-954-8246",
            "fax_number": "978-454-3135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 NEW CASTER DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018541221",
            "telephone_number": "978-954-8246",
            "fax_number": "978-454-3135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUGO",
        "first_name": "MOSES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MA",
            "license": "LN66802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.