Richard C Moak, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

3015765 Issued in KY

Practice address

110 29TH Ave N Ste 202
Nashville, TN 37203-1448

Phone

(615) 327-4304

NPI assigned

Jan 2, 2008

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 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Medstream Anesthesia PLLC

  • Anesthesiology Physician
  • Richardson, TX
  • NPI 1649616160

  Nurse Anesthetist, Certified Registered, TN

  Medicare reassignment NPD
• Anesthesia Medical Group, PC

  • Anesthesiology Physician
  • Nashville, TN
  • NPI 1215932413
  Medicare reassignment
• Anesthesia Medical Group, PC

  • Pain Medicine (Anesthesiology) Physician
  • Nashville, TN
  • NPI 1417225897
  NPD

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

{
    "created_epoch": "1199232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618876800000",
    "number": "1386829950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N STE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 29TH AVE N STE 202",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372031448",
            "telephone_number": "615-327-4304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOAK",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-01-02",
        "last_updated": "2021-04-20",
        "certification_date": "2021-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "78185",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KY",
            "license": "3015765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3600260",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100488",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE REGION SOUTH",
            "identifier": "620931432",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Elizabeth Mlodzik, RN
• MMS Knoxville Inc
• Mndfl Physio LLC
• Mo D Consulting LLC
• Ahmad Moadi
• Aaron Moberly, M.D.
• Anne Moberly
• Mobilab Express, Inc.
• Mobile Hearing of Tennessee
• Mobile Staffing Partners LLC Dba Evercare

• Certified Registered Nurse Anesthetist in Nashville, TN
• Providers in Nashville, TN by specialty
• Certified Registered Nurse Anesthetist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.