Active NPI
Shemica Moss, MHS
- Case Manager/Care Coordinator
- Lake Charles, LA
National Provider Identifier
1154794253
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- License
- 007627077
- Practice address
- 1639 Ryan St
Lake Charles, LA 70601-5948 - Phone
- (337) 602-6391
- Fax
- (337) 602-6392
- NPI assigned
- Nov 11, 2015
- 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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | 007627077 | LA | Primary |
Addresses
Primary practice location
1639 Ryan St
Lake Charles, LA 70601-5948
Mailing address
1639 Ryan St
Lake Charles, LA 70601-5948
Phone (337) 602-6391
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007627077 | Medicaid | LA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007627077 | LA | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1447200000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525651200000",
"number": "1154794253",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1639 RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706015948",
"telephone_number": "337-602-6391",
"fax_number": "337-602-6392"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1639 RYAN ST",
"city": "LAKE CHARLES",
"state": "LA",
"postal_code": "706015948",
"telephone_number": "337-602-6391",
"fax_number": "337-602-6392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSS",
"first_name": "SHEMICA",
"credential": "MHS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-11-11",
"last_updated": "2018-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "LA",
"license": "007627077",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007627077",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lake Charles, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.