Individual provider Active NPI

Maryn Jayne Moreni, FNP-C

  • Family Nurse Practitioner
  • Tempe, AZ
National Provider Identifier
1225517212
Registry record updated Aug 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP11528 Issued in AZ
Practice address
1840 E Baseline Rd Ste A1
Tempe, AZ 85283-1527
Phone
(480) 718-5400
NPI assigned
Aug 9, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2018

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 AP11528 AZ Primary

Addresses

Primary practice location

1840 E Baseline Rd Ste A1
Tempe, AZ 85283-1527

Mailing address

21228 E Excelsior Ave
Queen Creek, AZ 85142-5461
Phone (602) 882-2318

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
Credentials
Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1225517212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21228 E EXCELSIOR AVE",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851425461",
            "telephone_number": "602-882-2318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1840 E BASELINE RD STE A1",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852831527",
            "telephone_number": "480-718-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENI",
        "first_name": "MARYN",
        "middle_name": "JAYNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP11528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tempe, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.