Active NPI
Sandra Moreno-Christiansen, BSN, WHNP
- Women's Health Nurse Practitioner
- Dallas, TX
National Provider Identifier
1407876873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- 244159
- Practice address
- 3320 Live Oak St
5TH Floor
Dallas, TX 75204-6109 - Phone
- (214) 266-1200
- NPI assigned
- Jul 20, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | 244159 | TX | Primary |
Addresses
Primary practice location
3320 Live Oak St
5TH Floor
Dallas, TX 75204-6109
Mailing address
1620 Huron TRL
Plano, TX 75075-6708
Phone (972) 841-2104
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 139696218 | Medicaid | TX | |
| 244159 | Other | TX | STATE LICENSE |
| 10007060 | Other | TX | AMERIGROUP ID # |
| 89N734 | Other | TX | BLUE CROSS &BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Bachelor on Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 244159 | TX | MD | Women's Health Nurse Practitioner |
Interoperability endpoints
- sgonnell20501@direct.phhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412121600000",
"number": "1407876873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1620 HURON TRL",
"city": "PLANO",
"state": "TX",
"postal_code": "750756708",
"telephone_number": "972-841-2104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3320 LIVE OAK ST",
"address_2": "5TH FLOOR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752046109",
"telephone_number": "214-266-1200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORENO-CHRISTIANSEN",
"first_name": "SANDRA",
"name_prefix": "Ms.",
"credential": "BSN, WHNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-20",
"last_updated": "2014-10-01",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "TX",
"license": "244159",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "139696218",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "244159",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP ID #",
"identifier": "10007060",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS &BLUE SHIELD",
"identifier": "89N734",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.