Moss Gawain

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

2548 E Kenosha St
Broken Arrow, OK 74014-6712

Phone

(918) 355-0993

NPI assigned

Jul 26, 2023

Last updated

Feb 18, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Alessandra Gabrielle Ragusin Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1690329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1164103834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4103 S YALE AVE STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741356002",
            "telephone_number": "918-382-7300",
            "fax_number": "918-382-7302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2548 E KENOSHA ST",
            "city": "BROKEN ARROW",
            "state": "OK",
            "postal_code": "740146712",
            "telephone_number": "918-355-0993"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4103 S Yale Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741356002",
            "country_code": "US",
            "telephone_number": "918-382-7300",
            "fax_number": "918-382-7302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAWAIN",
        "first_name": "MOSS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-26",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALESSANDRA",
            "last_name": "RAGUSIN",
            "middle_name": "GABRIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Peer Specialist in Broken Arrow, OK
• Providers in Broken Arrow, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.