Mahaman Laouali Moussa, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

5004034 Issued in NC

Practice address

4692 Brownsboro Road
Winston - Salem, NC 27106

Phone

(336) 251-1114

Fax

(336) 251-1116

NPI assigned

Jul 29, 2008

Last updated

Jan 29, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Physicians Eldercare PA

  • General Practice Physician
  • Durham, NC
  • NPI 1023083268
  NPD (past)

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

{
    "created_epoch": "1217289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233187200000",
    "number": "1356507446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO ROAD",
            "city": "WINSTON - SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4692 BROWNSBORO ROAD",
            "city": "WINSTON - SALEM",
            "state": "NC",
            "postal_code": "27106",
            "telephone_number": "336-251-1114",
            "fax_number": "336-251-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUSSA",
        "first_name": "MAHAMAN",
        "middle_name": "LAOUALI",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-29",
        "last_updated": "2009-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "5004034",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "200356",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "2593362A",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mount Eagle Health Care Greensboro, LLC
• David L Mount, PSYD
• Martha Young Mount, PA-C
• Mountainview Skin Care PC
• Talal Imad Mousallem, M.D.
• Joshua Lee Mowery, FNP-C
• Karmen Maureen Mowery, LCSWA
• Sarah Moxley, MS/EDS, LPC
• Emily Christine Moya, PA-C
• Frank Joseph Moya, M.D.

• Nurse Practitioner in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2009; 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.