Individual provider Active NPI

Kimberly Ellen Moyer, RN

  • Pediatric Registered Nurse
  • San Antonio, TX
National Provider Identifier
1184124463
Registry record updated Feb 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Registered NurseTaxonomy code 163WP0200X
License
661037 Issued in TX
Practice address
7330 San Pedro Ave Ste 800
San Antonio, TX 78216-6268
Phone
(210) 737-8090
Fax
(866) 760-4570
NPI assigned
Feb 13, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Registered Nurse 163WP0200X 661037 TX Primary

Addresses

Primary practice location

7330 San Pedro Ave Ste 800
San Antonio, TX 78216-6268

Mailing address

2155 Mountain Mist
San Antonio, TX 78258-4913
Phone (210) 363-3232

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)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
661037TXMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Management & Business Associates, Inc. Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1184124463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 MOUNTAIN MIST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584913",
            "telephone_number": "210-363-3232",
            "fax_number": "866-760-4570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 SAN PEDRO AVE STE 800",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782166268",
            "telephone_number": "210-737-8090",
            "fax_number": "866-760-4570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "KIMBERLY",
        "middle_name": "ELLEN",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "TX",
            "license": "661037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.