Individual provider Active NPI

Nancy Anne Moffatt, FNP

  • Nurse Practitioner
  • Germantown, TN
National Provider Identifier
1346443694
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APN0000005703 Issued in TN
Practice address
7600 Wolf River Blvd
Suite 120
Germantown, TN 38138-1785
Phone
(901) 755-5300
Fax
(901) 682-1362
NPI assigned
Jun 6, 2007
Last updated
Dec 17, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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 APN0000005703 TN Primary

Addresses

Primary practice location

7600 Wolf River Blvd
Suite 120
Germantown, TN 38138-1785

Mailing address

PO Box 2757
Cordova, TN 38088-2757
Phone (901) 755-5300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20070915000248 TN Practitioner - Nurse Practitioner 5698869071 Reassigns benefits to 1 organization
I20250822000647 MS Practitioner - Nurse Practitioner 5698869071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mid-South Ear Nose and Throat PCGroup PAC ID 3779568092, 32 clinicians

Practice addresses (Care Compare)

7164 Hacks Cross Rd
Suite 105 106
Olive Branch, MS 38654-4472
Phone (901) 755-5300

7378 Yale Rd
Bartlett, TN 38133-3604
Phone (901) 755-5300

7600 Wolf River Blvd
Suite 220
Germantown, TN 38138-1788
Phone (901) 755-5300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APN0000005703TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-South Ear, Nose, and Throat, P.C. CurrentSince Jul 1, 2007 Accepting new patients
North Internal Medicine, P. C. PastSince Nov 9, 2020 Accepting new patients

Locations

7164 Hacks Cross Rd
Ste 105106
Olive Branch, MS 38654

7378 Yale Rd
Bartlett, TN 38133
Phone (901) 387-0193

8001 Centerview Pkwy
Ste 202
Cordova, TN 38018

8090 Walnut Run Rd
Cordova, TN 38018
Phone (901) 509-8347

7600 Wolf River Blvd
Ste 120
Germantown, TN 38138

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1346443694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2757",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380882757",
            "telephone_number": "901-755-5300",
            "fax_number": "901-753-9659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 WOLF RIVER BLVD",
            "address_2": "SUITE 120",
            "city": "GERMANTOWN",
            "state": "TN",
            "postal_code": "381381785",
            "telephone_number": "901-755-5300",
            "fax_number": "901-682-1362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOFFATT",
        "first_name": "NANCY",
        "middle_name": "ANNE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "APN0000005703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Germantown, TN

Sources for this page

Verify at the official NPI Registry.