Jeffery H Mooneyham, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1109518 Issued in AL

Practice address

4350 Cleveland Ave
Altoona, AL 35952

Phone

(205) 589-6361

NPI assigned

Jun 28, 2016

Last updated

Sep 15, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jeffery H Harris Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Certified Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/HDGBCD
• FHIR API: https://fhir4.healow.com/fhir/r4/HEDJAD
• Direct secure messaging: jmooneyham607193@direct.ochin.org

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.

• Medical Asset Group, LLC

  • Family Medicine Physician
  • Crossville, AL
  • NPI 1720595762
  Medicare reassignment NPD
• Quality of Life Health Services Inc

  dba Quality of Life Health Complex

  • Community Health Clinic/Center
  • Gadsden, AL
  • NPI 1447200977
  Medicare reassignment NPD
• Medical Asset Group, LLC

  • Family Medicine Physician
  • Albertville, AL
  • NPI 1194232132
  NPD
• Quality of Life Health Services, Inc

  dba Calhoun Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Anniston, AL
  • NPI 1013339209
  NPD
• Quality of Life Health Services, Inc

  dba Cleburne Quality Health Care

  • Federally Qualified Health Center (FQHC)
  • Heflin, AL
  • NPI 1467620989
  NPD
• Quality of Life Health Services, Inc

  • Community Health Clinic/Center
  • Walnut Grove, AL
  • NPI 1588615959
  NPD
• Agape Medicine, LLC

  • Family Medicine Physician
  • Snead, AL
  • NPI 1750907507
  NPD (past)
• Boaz Family Medicine, PC

  • Clinic/Center
  • Boaz, AL
  • NPI 1790840775
  NPD (past)

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

{
    "created_epoch": "1467072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1134570500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 OHARA DR",
            "city": "ALBERTVILLE",
            "state": "AL",
            "postal_code": "359502596",
            "telephone_number": "256-243-2430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 CLEVELAND AVE",
            "city": "ALTOONA",
            "state": "AL",
            "postal_code": "35952",
            "telephone_number": "205-589-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEYHAM",
        "first_name": "JEFFERY",
        "middle_name": "H",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-28",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-109518",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1109518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEFFERY",
            "last_name": "HARRIS",
            "middle_name": "H",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Fire Within Therapy
• John Morgan Gentry, RPH
• Jamie Grant
• Klein Drug Shoppe, Inc
• Heather Laughlin, COTA
• Southern Divine Family Medical Center LLC (United Doctors Family Medical Center - Altoona)
• Perry L Swann, MD
• Angie Vaughan, RPH
• Kyndal Sanford Washburn
• Amanda McCormick Willis, CRNP

• Family Nurse Practitioner in Altoona, AL
• Providers in Altoona, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; 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.