Active NPI
Janet Marlene Moreland, PA
- Physician Assistant
- De Kalb, TX
National Provider Identifier
1174785687
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA04056
- Practice address
- 1250 S Runnels St
De Kalb, TX 75559-2317 - Phone
- (903) 667-2273
- Fax
- (903) 667-7597
- NPI assigned
- Jun 26, 2008
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA04056 | TX | Primary |
Addresses
Primary practice location
1250 S Runnels St
De Kalb, TX 75559-2317
Mailing address
1250 S Runnels St
De Kalb, TX 75559-2317
Phone (903) 667-2273
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)
- Enrolled
- Credentials
- Physician Assistant
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214438400000",
"number": "1174785687",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1250 S RUNNELS ST",
"city": "DE KALB",
"state": "TX",
"postal_code": "755592317",
"telephone_number": "903-667-2273",
"fax_number": "903-667-7597"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1250 S RUNNELS ST",
"city": "DE KALB",
"state": "TX",
"postal_code": "755592317",
"telephone_number": "903-667-2273",
"fax_number": "903-667-7597"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORELAND",
"first_name": "JANET",
"middle_name": "MARLENE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2008-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA04056",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in De Kalb, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.