Individual provider Active NPI

Amber Jewel Moody, APRN

  • Family Nurse Practitioner
  • Searcy, AR
National Provider Identifier
1184284804
Registry record updated Aug 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
121559 Issued in AR
Practice address
3214 E Race Ave
Searcy, AR 72143-9307
Phone
(501) 259-0420
NPI assigned
Jun 14, 2019
Last updated
Aug 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2019

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 121559 AR Primary

Addresses

Primary practice location

3214 E Race Ave
Searcy, AR 72143-9307

Mailing address

23 Willard St
Ward, AR 72176-9307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20191113002586 AR Practitioner - Nurse Practitioner 8224460266 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
121559ARMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Arkansas Heart Hospital Rural Health Services, LLC CurrentSince Oct 14, 2019 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Oct 14, 2019 Accepting new patients
Arkansas Heart Hospital, LLC CurrentSince Oct 14, 2019 Accepting new patients

Locations

7 Shackleford West Blvd
Little Rock, AR 72211
Phone (501) 614-3671

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": "1560470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564617600000",
    "number": "1184284804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 WILLARD ST",
            "city": "WARD",
            "state": "AR",
            "postal_code": "721769307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3214 E RACE AVE",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721439307",
            "telephone_number": "501-259-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "AMBER",
        "middle_name": "JEWEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-14",
        "last_updated": "2019-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "121559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

Verify at the official NPI Registry.