Deanna Moorman, FNP-BC

Primary specialty

Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X

License

209011286 Issued in IL

Practice address

2023 Vadalabene Dr
Suite 200
Maryville, IL 62062-5630

Phone

(618) 288-7408

NPI assigned

Jul 28, 2014

Sex

Female

Sole proprietor

Yes

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

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Christina L Midkiff MD SC

  • Specialist
  • Maryville, IL
  • NPI 1518031558
  Medicare reassignment NPD

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728950400000",
    "number": "1134537632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 VADALABENE DR",
            "address_2": "SUITE 200",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625630",
            "telephone_number": "618-288-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 VADALABENE DR",
            "address_2": "SUITE 200",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625630",
            "telephone_number": "618-288-7408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORMAN",
        "first_name": "DEANNA",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-07-28",
        "last_updated": "2024-10-15",
        "certification_date": "2024-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IL",
            "license": "209011286",
            "primary": false
        },
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "IL",
            "license": "209011286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Miller, MD
• Ann LK Millikin, LCPC
• Mindful Priority Counseling LLC
• Mindweal Health, PLLC
• Mohamed Megahy M.D. LTD.
• Amy D Morby, L.C.S.W.
• Cynthia Moreno, MS CCC-SLP
• Jennifer L. Moss, OT
• Haresh K Motwani, MD.
• Moxie Pelvic Health and Wellness, PLLC

• Obstetrics & Gynecology Nurse Practitioner in Maryville, IL
• Providers in Maryville, IL by specialty
• Obstetrics & Gynecology Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.