Individual provider Active NPI

William Moran

  • Certified Registered Nurse Anesthetist
  • O Fallon, MO
National Provider Identifier
1457970899
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
083092-23 Issued in NH
Practice address
910 Daffodil Ridge Dr
O Fallon, MO 63366-7760
Phone
(314) 780-2257
NPI assigned
Apr 15, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2014020992 MO
Certified Registered Nurse Anesthetist 367500000X 083092-23 NH Primary

Addresses

Primary practice location

910 Daffodil Ridge Dr
O Fallon, MO 63366-7760

Mailing address

910 Daffodil Ridge Dr
O Fallon, MO 63366-7760
Phone (314) 780-2257

Other practice location 1

1 Medical Center Dr
Lebanon, NH 03756-0001
Phone (603) 650-5000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200819001042 NH Practitioner - Certified Registered Nurse Anesthetist (Crna) 1153747373 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Amoskeag Anesthesia PLLCGroup PAC ID 1759375983, 165 clinicians

Practice addresses (Care Compare)

1 Elliot Way
Manchester, NH 03103-3502
Phone (603) 663-2431

Hospital & facility affiliations

  • Elliot Hospital Hospital, Manchester, NH, CCN 300012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2014020992MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Dartmouth-Hitchcock Clinic CurrentSince Apr 6, 2023 Accepting new patients
Anesthesia Care Group PC CurrentSince Jul 7, 2020 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 31, 2024 Accepting new patients
Mary Hitchcock Memorial Hospital Current Accepting new patients
Catholic Medical Center CurrentSince Dec 30, 2023 Accepting new patients
Matrix Pathology and Laboratory Services PLLC Current Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Dec 31, 2024 Accepting new patients
Amoskeag Anesthesia, PLLC Nurse Anesthetist, Certified Registered CurrentSince Mar 26, 2025 Accepting new patients

Locations

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

88 McGregor St
Ste 303
Manchester, NH 03102
Phone (603) 647-9325

1 Elliot Way
Manchester, NH 03103
Phone (603) 663-2271

100 McGregor St
Manchester, NH 03102
Phone (603) 663-6931

100 McGregor St
Ste C234
Manchester, NH 03102
Phone (603) 663-6180

185 Queen City Ave
Manchester, NH 03101
Phone (603) 314-6900

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1586908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1457970899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 DAFFODIL RIDGE DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667760",
            "telephone_number": "314-780-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 DAFFODIL RIDGE DR",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633667760",
            "telephone_number": "314-780-2257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037560001",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "WILLIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-15",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2014020992",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NH",
            "license": "083092-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.