Noelle Mooneyham, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN11000132 Issued in FL

Practice address

212 S Florida St
Bushnell, FL 33513-6703

Phone

(352) 793-2441

NPI assigned

Dec 27, 2018

Last updated

Dec 27, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lowell F. Clark MD PAGroup PAC ID 7416918370, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Lowell F. Clark MD PA

  • Internal Medicine Physician
  • Bushnell, FL
  • NPI 1629278882
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1545868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545868800000",
    "number": "1154893477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 S FLORIDA ST",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335136703",
            "telephone_number": "352-793-2441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 S FLORIDA ST",
            "city": "BUSHNELL",
            "state": "FL",
            "postal_code": "335136703",
            "telephone_number": "352-793-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOONEYHAM",
        "first_name": "NOELLE",
        "credential": "ARNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-27",
        "last_updated": "2018-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "APRN11000132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Seshidhar Madamanchi
• Cary Mattos
• Leslie Mead
• Brigitte Mitchell
• Gwendolyn Denese Mobley
• Sheri F Morgan, PTA
• Sarah J Moyer, PHARMD.
• Diana K Mullin
• Vijaya L Nagabhairu, MD
• Raihna Maklay Newcomb, PTA

• Nurse Practitioner in Bushnell, FL
• Providers in Bushnell, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.