Individual provider Active NPI

Nancy K. Moughrabi, FNP

  • Family Nurse Practitioner
  • Chattanooga, TN
National Provider Identifier
1225261886
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN0000014187 Issued in TN
Practice address
171 Baylor School Rd
Chattanooga, TN 37405-2507
Phone
(423) 267-8506
Fax
(423) 757-2874
NPI assigned
Aug 31, 2009
Last updated
Sep 25, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 205058 GA
Family Nurse Practitioner 363LF0000X APN0000014187 TN Primary

Addresses

Primary practice location

171 Baylor School Rd
Chattanooga, TN 37405-2507

Mailing address

4976 Alpha LN
Hixson, TN 37343-5470
Phone (423) 308-0280

Other identifiers 2

IdentifierTypeStateIssuer
1522117MedicaidTN
14187OtherTNTN LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20110301000571 TN Practitioner - Nurse Practitioner 5496936262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
205058GAMDNurse Practitioner
APN0000014187TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
One Doc PLLC CurrentSince Jan 1, 2021 Accepting new patients

Locations

1067 Riverfront Pkwy
Ste 201
Chattanooga, TN 37402
Phone (423) 822-2387

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": "1251676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1225261886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4976 ALPHA LN",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435470",
            "telephone_number": "423-308-0280",
            "fax_number": "423-308-0281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 BAYLOR SCHOOL RD",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374052507",
            "telephone_number": "423-267-8506",
            "fax_number": "423-757-2874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUGHRABI",
        "first_name": "NANCY",
        "middle_name": "K.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-31",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "GA",
            "license": "205058",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000014187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1522117",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN LICENSE",
            "identifier": "14187",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

Verify at the official NPI Registry.