Individual provider Active NPI

Sandra Moreno-Christiansen, BSN, WHNP

  • Women's Health Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1407876873
Registry record updated Oct 1, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
244159 Issued in TX
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

Updated by the provider on Oct 1, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
139696218MedicaidTX
244159OtherTXSTATE LICENSE
10007060OtherTXAMERIGROUP ID #
89N734OtherTXBLUE 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

LicenseStateTypeSpecialty
244159TXMDWomen's Health Nurse Practitioner

Interoperability endpoints

  • Direct secure messaging: 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.

Verify at the official NPI Registry.