Tim I Moomaw, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

COA.17111-NP Issued in OH

Practice address

100 Jackson Pike
Gallipolis, OH 45631-1560

Phone

(740) 446-5000

NPI assigned

Feb 18, 2015

Sex

Male

Sole proprietor

No

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

Enrolled in OH

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 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bloomington Medical Services LLCGroup PAC ID 9032297627, 106 clinicians

Cleveland ClinicGroup PAC ID 1850203555, 6,954 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cleveland Clinic Hospital, Cleveland, OH, CCN 360180
• Wooster Community Hospital Hospital, Wooster, OH, CCN 360036

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Bloomington Medical Services LLC

  • Internal Medicine Physician
  • Wooster, OH
  • NPI 1528246683
  Medicare reassignment Care Compare group NPD
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Medicare reassignment Care Compare group NPD
• Cleveland Clinic Mercy Hospital

  • General Acute Care Hospital
  • Canton, OH
  • NPI 1366433195
  Medicare reassignment NPD
• Knox Emergency Services, LLC

  • Emergency Medicine Physician
  • Mount Vernon, OH
  • NPI 1861450066

  Nurse Practitioner

  Medicare reassignment NPD
• Magis Emergency Medicine LLC

  • Emergency Medicine Physician
  • Parma, OH
  • NPI 1801287511
  Medicare reassignment NPD
• Mid-Ohio Emergency Group, LLC

  • Emergency Medicine Physician
  • Mansfield, OH
  • NPI 1881164010

  Nurse Practitioner

  Medicare reassignment NPD
• Physicians Link Center LLC

  • Emergency Medicine Physician
  • Elyria, OH
  • NPI 1235172925
  Medicare reassignment NPD
• Ues Ahuja LLC

  • Emergency Medicine Physician
  • Beachwood, OH
  • NPI 1467883934
  Medicare reassignment NPD
• Ues Geauga, LLC

  • Emergency Medicine Physician
  • Chardon, OH
  • NPI 1841242997
  Medicare reassignment NPD
• Union Physician Services, LLC

  • Family Medicine Physician
  • Dover, OH
  • NPI 1215169826
  Medicare reassignment NPD
• Wooster Clinic, LLC

  • Multi-Specialty Clinic/Center
  • Wooster, OH
  • NPI 1033135009
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  Nurse Practitioner, OH

  Medicare reassignment NPD

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

• City of Wooster

  • General Acute Care Hospital
  • Wooster, OH
  • NPI 1437156247
  Care Compare affiliation
• The Cleveland Clinic Foundation

  • General Acute Care Hospital
  • Cleveland, OH
  • NPI 1679525919
  Care Compare affiliation

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424217600000",
    "number": "1386035954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 REMIT DR",
            "address_2": "#1367",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606751367",
            "telephone_number": "866-916-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 JACKSON PIKE",
            "city": "GALLIPOLIS",
            "state": "OH",
            "postal_code": "456311560",
            "telephone_number": "740-446-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOMAW",
        "first_name": "TIM",
        "middle_name": "I",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-18",
        "last_updated": "2015-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "COA.17111-NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kayla R. Mollohan, LSW
• Ashley L. Monsrud, MD
• Desiree Montgomery
• Tisha Montgomery
• Emma McKenzie Moodispaugh, STNA
• Alisha Moon, CDCA
• Allie J Moore, LPN
• Ruth Elizabeth Moore, APRN, CNP
• Amber Morehart
• Kelly J Morgan

• Nurse Practitioner in Gallipolis, OH
• Providers in Gallipolis, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.