Gwendolyn Calla Moore, CPNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

10129 Issued in CT

Practice address

148 East Ave Ste 3G
Norwalk, CT 06851-5727

Phone

(203) 838-4034

Fax

(203) 853-6361

NPI assigned

Feb 22, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gmoore19834@direct.ynhh.org

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.

• Fairfield County Allergy Asthma & Immunology Associates PC

  • Allergy & Immunology Physician
  • Norwalk, CT
  • NPI 1083705891
  NPD

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

{
    "created_epoch": "1361491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1114267572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 3G",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515727",
            "telephone_number": "203-838-4034",
            "fax_number": "203-853-6351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 EAST AVE STE 3G",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515727",
            "telephone_number": "203-838-4034",
            "fax_number": "203-853-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GWENDOLYN",
        "middle_name": "CALLA",
        "name_prefix": "Ms.",
        "credential": "CPNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-02-22",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "382340",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "10129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moaiad Mohammed Ibrahim Hussein, M.D.
• Cecile Diane Moliva Anendaga, MD
• Karen Lin Moll
• Brian V Monahan, MD
• Astrid Monsalve-Smith, D.C.
• Jennifer I Moore, MD
• Joanna Louise Moore, MD
• Monica Moore, APRN
• Carmen Morales, APRN
• Edward Moran, LCSW

• Pediatric Nurse Practitioner in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Pediatric Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.

Verify at the official NPI Registry.