Active NPI
Kimberly J Moeller, C.N.S.
- Clinical Nurse Specialist
- Akron, OH
National Provider Identifier
1134368780
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Nurse Specialist
- License
- NS10499
- Practice address
- 161 N Forge St
Ste. 198
Akron, OH 44304-1468 - Phone
- (330) 376-1043
- Fax
- (330) 376-9951
- NPI assigned
- Feb 5, 2009
- Last updated
- Mar 23, 2011
- 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 |
|---|---|---|---|---|
| Clinical Nurse Specialist | 364S00000X | NS10499 | OH | Primary |
Addresses
Primary practice location
161 N Forge St
Ste. 198
Akron, OH 44304-1468
Mailing address
525 E Market St
PO Box 2090
Akron, OH 44304-1619
Phone (330) 996-8603
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2986112 | Medicaid | OH |
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
- Certified Nurse Specialist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| NS10499 | OH | MD | Clinical Nurse Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1300838400000",
"number": "1134368780",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 E MARKET ST",
"address_2": "PO BOX 2090",
"city": "AKRON",
"state": "OH",
"postal_code": "443041619",
"telephone_number": "330-996-8603",
"fax_number": "330-996-8695"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "161 N FORGE ST",
"address_2": "STE. 198",
"city": "AKRON",
"state": "OH",
"postal_code": "443041468",
"telephone_number": "330-376-1043",
"fax_number": "330-376-9951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOELLER",
"first_name": "KIMBERLY",
"middle_name": "J",
"credential": "C.N.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-05",
"last_updated": "2011-03-23",
"status": "A"
},
"taxonomies": [
{
"code": "364S00000X",
"taxonomy_group": "",
"desc": "Clinical Nurse Specialist",
"state": "OH",
"license": "NS10499",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2986112",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Akron, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.