Active NPI
Cheri Lyn Moore, C.R.N.A.
- Certified Registered Nurse Anesthetist
- Mesquite, TX
National Provider Identifier
1205837358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 235104
- Practice address
- 3500 Interstate 30 at Motley Dr.
Mesquite, TX 75150 - Phone
- (972) 698-2051
- NPI assigned
- Aug 10, 2005
- Last updated
- May 18, 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 235104 | TX | Primary |
Addresses
Primary practice location
3500 Interstate 30 at Motley Dr.
Mesquite, TX 75150
Mailing address
400 Valverde CT
Southlake, TX 76092-5935
Phone (817) 481-7544
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 002291501 | Medicaid | TX | |
| 090153005 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000000 | TX | MD | Health Educator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeshore Anesthesia Group, PLLC | Nurse Anesthetist, Certified Registered | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Certified Registered Nurse Anesthetist
- Dallas, TX
- NPI 1689611550
Nurse Anesthetist, Certified Registered
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211068800000",
"number": "1205837358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 VALVERDE CT",
"city": "SOUTHLAKE",
"state": "TX",
"postal_code": "760925935",
"telephone_number": "817-481-7544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 INTERSTATE 30 AT MOTLEY DR.",
"city": "MESQUITE",
"state": "TX",
"postal_code": "75150",
"telephone_number": "972-698-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CHERI",
"middle_name": "LYN",
"name_prefix": "Ms.",
"credential": "C.R.N.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-10",
"last_updated": "2008-05-18",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TX",
"license": "235104",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "002291501",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "090153005",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 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.