Individual provider Active NPI

Carolyn Ann Moscone

  • Acute Care Nurse Practitioner
  • Troy, MI
National Provider Identifier
1235062803
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
4704418159 Issued in MI
Practice address
5440 Corporate Dr Ste Dr
Troy, MI 48098-2646
Phone
(866) 902-4000
NPI assigned
Jun 4, 2026
Last updated
Jun 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 4704418159 MI Primary

Addresses

Primary practice location

5440 Corporate Dr Ste Dr
Troy, MI 48098-2646

Mailing address

25386 Witherspoon St
Farmington Hills, MI 48335-1370
Phone (248) 308-4309

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4704418159MIMDAcute Care Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1235062803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25386 WITHERSPOON ST",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483351370",
            "telephone_number": "248-308-4309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5440 CORPORATE DR STE DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480982646",
            "telephone_number": "866-902-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSCONE",
        "first_name": "CAROLYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704418159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

Verify at the official NPI Registry.