Individual provider Active NPI

Paula Denise Tedin-Moschovas, DNP, ACNP-BC

  • Acute Care Nurse Practitioner
  • Jackson, TN
National Provider Identifier
1265960751
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
APN0000019721 Issued in TN
Practice address
2016 Greystone SQ
Jackson, TN 38305-3575
Phone
(731) 664-1773
Fax
(731) 664-1751
NPI assigned
May 26, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 APN0000019721 TN
Acute Care Nurse Practitioner 363LA2100X APN0000019721 TN Primary

Addresses

Primary practice location

2016 Greystone SQ
Jackson, TN 38305-3575

Mailing address

2016 Greystone SQ
Jackson, TN 38305-3575
Phone (731) 664-1773

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
I20171016000285 TN Practitioner - Nurse Practitioner 3072888262 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APN0000019721TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Michael E Steuer, MD, PC CurrentSince May 31, 2017 Accepting new patients
Michael E Steuer MD PC CurrentSince May 31, 2017 Accepting new patients

Locations

1004 Greystone Sq
Jackson, TN 38305
Phone (731) 664-1773

2016 Greystone Sq
Jackson, TN 38305
Phone (731) 664-1773

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1495756800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1265960751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053575",
            "telephone_number": "731-664-1773",
            "fax_number": "731-664-1751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053575",
            "telephone_number": "731-664-1773",
            "fax_number": "731-664-1751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEDIN-MOSCHOVAS",
        "first_name": "PAULA",
        "middle_name": "DENISE",
        "credential": "DNP, ACNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-26",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000019721",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TN",
            "license": "APN0000019721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

Verify at the official NPI Registry.