Individual provider Active NPI

Jeanne Sharee Moss, ARNP

  • Nurse Practitioner
  • Spokane, WA
National Provider Identifier
1205076601
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
IP60068769 Issued in WA
Practice address
101 W 8TH Ave
Spokane, WA 99204-2307
Phone
(509) 474-4599
Fax
(509) 474-4250
NPI assigned
Feb 24, 2009
Last updated
Dec 16, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X IP60068769 WA Primary

Addresses

Primary practice location

101 W 8TH Ave
Spokane, WA 99204-2307

Mailing address

PO Box 12229
Westminster, CA 92685-2229
Phone (888) 432-2088

Other identifiers 1

IdentifierTypeStateIssuer
9661109MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20090407000276 WA Practitioner - Nurse Practitioner 4183771298 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
IP60068769WAMDNurse Practitioner

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, 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": "1235433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1260921600000",
    "number": "1205076601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12229",
            "city": "WESTMINSTER",
            "state": "CA",
            "postal_code": "926852229",
            "telephone_number": "888-432-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 W 8TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042307",
            "telephone_number": "509-474-4599",
            "fax_number": "509-474-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JEANNE",
        "middle_name": "SHAREE",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-24",
        "last_updated": "2009-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "IP60068769",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9661109",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.