Individual provider Active NPI

Patricia Ann Moran, NP

  • Adult Health Nurse Practitioner
  • Cleveland, OH
National Provider Identifier
1396943387
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
NP-08575 Issued in OH
Practice address
10701 East Blvd
111K (W)
Cleveland, OH 44106-1702
Phone
(216) 791-3800
Fax
(216) 231-3470
NPI assigned
Jul 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X RN-201059 OH
Adult Health Nurse Practitioner 363LA2200X NP-08575 OH Primary

Addresses

Primary practice location

10701 East Blvd
111K (W)
Cleveland, OH 44106-1702

Mailing address

5391 Decker Rd
North Olmsted, OH 44070-4229
Phone (440) 779-9734

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20230313002970 FL Practitioner - Nurse Practitioner 2769568401 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN-201059OHMDGeneral Practice Registered Nurse
NP-08575OHMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Innovative Infusions, LLC CurrentSince Nov 29, 2022 Accepting new patients
Innovative Infusions, LLC. Current Accepting new patients

Locations

2160 Gulf To Bay Blvd
Clearwater, FL 33765
Phone (727) 387-3092

3540 Pine Ridge Rd
Ste 2
Naples, FL 34109
Phone (239) 544-3151

2824 University Pkwy
Sarasota, FL 34243
Phone (941) 477-2836

3033 W President George Bush Hwy
Ste 100
Plano, TX 75075
Phone (877) 365-5566

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1396943387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5391 DECKER RD",
            "city": "NORTH OLMSTED",
            "state": "OH",
            "postal_code": "440704229",
            "telephone_number": "440-779-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10701 EAST BLVD",
            "address_2": "111K (W)",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441061702",
            "telephone_number": "216-791-3800",
            "fax_number": "216-231-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "OH",
            "license": "RN-201059",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OH",
            "license": "NP-08575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, OH

Sources for this page

Verify at the official NPI Registry.