Active NPI
Amy Jewel Moorhead, PA
- Physician Assistant
- Fort Belvoir, VA
National Provider Identifier
1093872772
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110005652
- Practice address
- 9300 Dewitt Loop
Fort Belvoir, VA 22060-5285 - Phone
- (571) 231-2191
- Fax
- (712) 316-6075
- NPI assigned
- Jan 2, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110005652 | VA | Primary |
Addresses
Primary practice location
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Mailing address
9300 Dewitt Loop
Fort Belvoir, VA 22060-5285
Phone (571) 231-2191
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701648000000",
"number": "1093872772",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605285",
"telephone_number": "571-231-2191",
"fax_number": "571-231-6607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9300 DEWITT LOOP",
"city": "FORT BELVOIR",
"state": "VA",
"postal_code": "220605285",
"telephone_number": "571-231-2191",
"fax_number": "712-316-6075"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORHEAD",
"first_name": "AMY",
"middle_name": "JEWEL",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-02",
"last_updated": "2023-12-04",
"certification_date": "2023-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110005652",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Belvoir, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.