Individual provider Active NPI

Annabel K. Moreno, R.N.

  • Registered Nurse
  • Anchorage, AK
National Provider Identifier
1184766057
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
24598 Issued in AK
Practice address
3760 Piper Street
Suite Ll139
Anchorage, AK 99504-7459
Phone
(907) 212-6233
Fax
(907) 563-3217
NPI assigned
Feb 13, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 24598 AK Primary

Addresses

Primary practice location

3760 Piper Street
Suite Ll139
Anchorage, AK 99504-7459

Mailing address

PO Box 196276
Anchorage, AK 99519-6276
Phone (907) 212-6233

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAK

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
24598AKMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services - Washington 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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184766057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 196276",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995196276",
            "telephone_number": "907-212-6233",
            "fax_number": "907-563-3217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 PIPER STREET",
            "address_2": "SUITE LL139",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995047459",
            "telephone_number": "907-212-6233",
            "fax_number": "907-563-3217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "ANNABEL",
        "middle_name": "K.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AK",
            "license": "24598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.