Individual provider Active NPI

Miranda Elizabeth Moss, APRN, FNP-C

  • Nurse Practitioner
  • Bluffton, SC
National Provider Identifier
1326697442
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
23205 Issued in SC
Practice address
1 Burnt Church Rd Ste a
Bluffton, SC 29910-6405
Phone
(843) 706-2185
Fax
(843) 299-5693
NPI assigned
Sep 11, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 23205 SC Primary

Addresses

Primary practice location

1 Burnt Church Rd Ste a
Bluffton, SC 29910-6405

Mailing address

PO Box 23321
New York, NY 10087-3321
Phone (843) 792-6200

Other identifiers 1

IdentifierTypeStateIssuer
NP6357MedicaidSC

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.musc.edu Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191210000902 SC Practitioner - Nurse Practitioner 1557794369 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Musc Community Physicians Current Accepting new patients
Beaufort County Memorial Hospital CurrentSince Oct 7, 2019 Accepting new patients
Musc Community Physicians CurrentSince Jan 12, 2023 Accepting new patients
Beaufort County Memorial Hospital CurrentSince Oct 7, 2019 Accepting new patients
Beaufort County Memorial Hospital Current Accepting new patients
Beaufort County Memorial Hospital CurrentSince Oct 7, 2019 Accepting new patients
Musc Community Physicians CurrentSince Jan 12, 2023 Accepting new patients
Beaufort County Memorial Hospital Past Accepting new patients

Locations

506 North St
Bamberg, SC 29003
Phone (803) 245-6290

989 Ribaut Rd
Ste 103
Beaufort, SC 29902
Phone (843) 522-5351

300 Midtown Dr
Beaufort, SC 29906
Phone (843) 379-7746

955 Ribaut Rd
#C
Beaufort, SC 29902

955 Ribaut Rd
Beaufort, SC 29902
Phone (803) 522-5200

1 Burnt Church Rd
#A
Bluffton, SC 29910
Phone (843) 706-2185

1680 Ribaut Rd
Port Royal, SC 29935
Phone (843) 522-7600

1000 Pine St W
Varnville, SC 29944
Phone (803) 943-5228

Interoperability endpoints

  • Direct secure messaging: miranda.moss.1@15816.direct.athenahealth.com

Organizations & group practices 8

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": "1568160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1326697442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23321",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100873321",
            "telephone_number": "843-792-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BURNT CHURCH RD STE A",
            "city": "BLUFFTON",
            "state": "SC",
            "postal_code": "299106405",
            "telephone_number": "843-706-2185",
            "fax_number": "843-299-5693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "MIRANDA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-11",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "SC",
            "license": "23205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP6357",
            "state": "SC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.musc.edu",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "1 Burnt Church Rd Ste A",
            "city": "Bluffton",
            "state": "SC",
            "country_code": "US",
            "postal_code": "299106405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Bluffton, SC

Sources for this page

Verify at the official NPI Registry.