Michael J Moldenhauer, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

2010040721 Issued in MO

Practice address

624 Old Saint Marys Rd
Suite a
Perryville, MO 63775-1837

Phone

(573) 547-3232

Fax

(573) 547-3231

NPI assigned

Dec 31, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Memorial Hospital

  • Critical Access Hospital
  • Chester, IL
  • NPI 1851390132
  Medicare reassignment NPD
• Memorial Hospital

  • Institutional Pharmacy
  • Chester, IL
  • NPI 1023603289
  NPD
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

  • Rural Health Clinic/Center
  • Coulterville, IL
  • NPI 1083721567
  NPD (past)
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

  • Rural Health Clinic/Center
  • Sparta, IL
  • NPI 1740395045
  NPD (past)
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

  • Rural Health Clinic/Center
  • Sparta, IL
  • NPI 1750497194
  NPD (past)
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

  • Rural Health Clinic/Center
  • Marissa, IL
  • NPI 1922114800
  NPD (past)
• Sparta Community Hospital D/B/a Quality Healthcare Clinics

  • Multi-Specialty Clinic/Center
  • Sparta, IL
  • NPI 1922242130
  NPD (past)

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

{
    "created_epoch": "1293753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1293753600000",
    "number": "1275837551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "624 OLD SAINT MARYS RD",
            "address_2": "SUITE A",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751837",
            "telephone_number": "573-547-3232",
            "fax_number": "573-547-3231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "624 OLD SAINT MARYS RD",
            "address_2": "SUITE A",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637751837",
            "telephone_number": "573-547-3232",
            "fax_number": "573-547-3231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLDENHAUER",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-12-31",
        "last_updated": "2010-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2010040721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mkalma, LLC
• Moeckel Chiropractic Physicians
• Keith James Moeckel, DC
• Ryan James Moeckel, DC.
• Megan Moldenhauer
• Monarch Rose LLC
• Amanda Rose Moore, APRN FNP-C
• James Morris, LCSW
• Anna Elizabeth Mueller, RPH
• New Life Mission Inn - Missouri

• Family Nurse Practitioner in Perryville, MO
• Providers in Perryville, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.