Noelle Mooneyham, ARNP
Individual provider Active NPI Nurse Practitioner · Bushnell, FL
NPI 1154893477 · NPPES record last updated Dec 27, 2018
Key facts
- NPI
- 1154893477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN11000132 (FL)
- Practice address
- 212 S Florida St
Bushnell, FL 33513-6703 - Phone
- (352) 793-2441
- NPI assigned
- Dec 27, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lowell F. Clark MD PA
Practice addresses (Care Compare)
212 S Florida St
Bushnell, FL 33513-6703
Phone (352) 793-2441
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190214000039 | FL | Practitioner - Nurse Practitioner | 4183962392 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN11000132 | FL | MD | Nurse Practitioner |
Networks
- Freedom Health HMO Network
- Optimum HealthCare HMO Network
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN11000132 | FL | Yes |
Addresses
Primary practice location
212 S Florida St
Bushnell, FL 33513-6703
Mailing address
212 S Florida St
Bushnell, FL 33513-6703
Phone (352) 793-2441
Other providers in Bushnell, FL
- Lula Frazier
- Cary Mattos
- Leslie Mead
- Brigitte Mitchell
- Gwendolyn Denese Mobley
- Sheri F Morgan
- Sarah J Moyer
- Diana K Mullin
- Vijaya L Nagabhairu
- Raihna Maklay Newcomb
All providers in Bushnell, FL · Nurse Practitioner in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 27, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.