Individual provider Active NPI

Shirley Kimberly Moretz, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Damascus, VA
National Provider Identifier
1295650323
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
0024197149 Issued in VA
Practice address
20660 McCann Rd
Damascus, VA 24236-2232
Phone
(423) 335-4904
NPI assigned
Aug 10, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X 0024197149 VA Primary

Addresses

Primary practice location

20660 McCann Rd
Damascus, VA 24236-2232

Mailing address

20660 McCann Rd
Damascus, VA 24236-2232
Phone (423) 335-4904

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

NPI Registry JSON

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

{
    "created_epoch": "1786320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786320000000",
    "number": "1295650323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20660 MCCANN RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242362232",
            "telephone_number": "423-335-4904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20660 MCCANN RD",
            "city": "DAMASCUS",
            "state": "VA",
            "postal_code": "242362232",
            "telephone_number": "423-335-4904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORETZ",
        "first_name": "SHIRLEY",
        "middle_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-08-10",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024197149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Damascus, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2026; 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.