Individual provider Active NPI

Jeffrey P Moomey, RNFA

  • Registered Nurse First Assistant
  • O Fallon, MO
National Provider Identifier
1265798904
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered Nurse First AssistantTaxonomy code 163WR0006X
License
071732 Issued in MO
Practice address
7827 Highway N
Suite 104
O Fallon, MO 63368-6704
Phone
(314) 620-1672
Fax
(636) 561-7159
NPI assigned
Apr 6, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse First Assistant 163WR0006X 071732 MO Primary

Addresses

Primary practice location

7827 Highway N
Suite 104
O Fallon, MO 63368-6704

Mailing address

7827 Highway N
Suite 104
O Fallon, MO 63368-6704
Phone (314) 620-1672

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
071732MOMDRegistered Nurse First Assistant

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333670400000",
    "number": "1265798904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7827 HIGHWAY N",
            "address_2": "SUITE 104",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686704",
            "telephone_number": "314-620-1672",
            "fax_number": "636-561-7159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7827 HIGHWAY N",
            "address_2": "SUITE 104",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633686704",
            "telephone_number": "314-620-1672",
            "fax_number": "636-561-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOMEY",
        "first_name": "JEFFREY",
        "middle_name": "P",
        "credential": "RNFA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WR0006X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Registered Nurse First Assistant",
            "state": "MO",
            "license": "071732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.