Beanca Sada Moss, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

328809-1 Issued in NY

Practice address

128 W Pleasant St Apt O2
Manlius, NY 13104-1716

Phone

(315) 427-7543

NPI assigned

Jan 26, 2019

Last updated

Jan 26, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1548460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548460800000",
    "number": "1326502105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 W PLEASANT ST APT O2",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041716",
            "telephone_number": "315-427-7543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 W PLEASANT ST APT O2",
            "city": "MANLIUS",
            "state": "NY",
            "postal_code": "131041716",
            "telephone_number": "315-427-7543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "BEANCA",
        "middle_name": "SADA",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-01-26",
        "last_updated": "2019-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "328809-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Mohabir MD PC
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• Emily Murray
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• Licensed Practical Nurse in Manlius, NY
• Providers in Manlius, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2019; 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.