Active NPI
Roberto Antonio Moreno, RN
- Adult Companion
- Whiting, IN
National Provider Identifier
1073275368
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Companion
- License
- 21-015157
- Practice address
- 2462 White Oak Ave
Whiting, IN 46394-2157 - Phone
- (219) 999-5869
- NPI assigned
- Oct 13, 2021
- Last updated
- Dec 12, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Adult Companion | 372600000X | 21-015157 | IN | Primary |
Addresses
Primary practice location
2462 White Oak Ave
Whiting, IN 46394-2157
Mailing address
PO Box 752
Whiting, IN 46394-0752
Phone (219) 999-5869
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21-015157 | IN | MD | Adult Companion |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| White Oak Home Care LLC | Adult Companion | Current | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1634083200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1733961600000",
"number": "1073275368",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 752",
"city": "WHITING",
"state": "IN",
"postal_code": "463940752",
"telephone_number": "219-999-5869"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2462 WHITE OAK AVE",
"city": "WHITING",
"state": "IN",
"postal_code": "463942157",
"telephone_number": "219-999-5869"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO",
"first_name": "ROBERTO",
"middle_name": "ANTONIO",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-10-13",
"last_updated": "2024-12-12",
"certification_date": "2024-12-12",
"status": "A"
},
"taxonomies": [
{
"code": "372600000X",
"taxonomy_group": "",
"desc": "Adult Companion",
"state": "IN",
"license": "21-015157",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Whiting, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.