Individual provider Active NPI

Sheila Diane Moss, FNP

  • Family Nurse Practitioner
  • Oklahoma City, OK
National Provider Identifier
1164982104
Registry record updated Dec 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
54738 Issued in OK
Practice address
11100 Hefner Pointe Dr Ste a
Oklahoma City, OK 73120-5049
Phone
(405) 839-7340
Fax
(405) 839-7341
NPI assigned
Mar 25, 2019
Last updated
Dec 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 54738 OK Primary

Addresses

Primary practice location

11100 Hefner Pointe Dr Ste a
Oklahoma City, OK 73120-5049

Mailing address

11326 NW 121St PL
Yukon, OK 73099-8141
Phone (405) 202-6913

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lmcancercenterHefner@directaddress.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK
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

Enrollment IDStateProvider typePAC IDDetails
I20191125000725 OK Practitioner - Nurse Practitioner 0446682827 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
NR Edmond LLCGroup PAC ID 5193174498, 3 clinicians

Practice addresses (Care Compare)

3520 S Boulevard
Suite 100
Edmond, OK 73013-5413
Phone (405) 495-7391

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Physicians Group LLC CurrentSince Aug 1, 2022 Accepting new patients
NR Edmond LLC CurrentSince Dec 4, 2023 Accepting new patients
Summit Medical Center Past Accepting new patients

Locations

3908 N Peniel Ave
Ste 450
Bethany, OK 73008

3520 S Boulevard
#100
Edmond, OK 73013
Phone (405) 495-7391

10021 S Western Ave
Oklahoma City, OK 73139
Phone (405) 692-9300

4400 Grant Blvd
Yukon, OK 73099
Phone (405) 467-4440

Interoperability endpoints

  • Direct secure messaging: lmcancercenterhefner@directaddress.net

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640044800000",
    "number": "1164982104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11326 NW 121ST PL",
            "city": "YUKON",
            "state": "OK",
            "postal_code": "730998141",
            "telephone_number": "405-202-6913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 HEFNER POINTE DR STE A",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731205049",
            "telephone_number": "405-839-7340",
            "fax_number": "405-839-7341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "SHEILA",
        "middle_name": "DIANE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2021-12-21",
        "certification_date": "2021-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "54738",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmcancercenterHefner@directaddress.net",
            "affiliation": "N",
            "endpointDescription": "Landmark Department Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11100 Hefner Pointe Dr Ste A",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731205049",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

Verify at the official NPI Registry.