Susan Joana Moore, N.P.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APRN001004 Issued in NV

Practice address

975 Ryland St Ste 100
Reno, NV 89502-1669

Phone

(775) 982-5000

Fax

(775) 982-5225

NPI assigned

Jul 18, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• Churchill Mangat Emergency Group PC

  • Emergency Medicine Physician
  • Fallon, NV
  • NPI 1881905149

  Nurse Practitioner

  NPD (past)

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

{
    "created_epoch": "1216339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1467617407",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 KUENZLI ST STE 202",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895020837",
            "telephone_number": "775-982-4590",
            "fax_number": "775-982-5496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 RYLAND ST STE 100",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895021669",
            "telephone_number": "775-982-5000",
            "fax_number": "775-982-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "JOANA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-18",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APRN001004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1467617407",
            "state": "NV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12215917",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martin Louis Moore, APN RN
• Michael Kevin Moore, M.D., M.S.
• Michelle Ann Moore, RNFA
• Mitchell Moore
• Shay Moore, RN
• Timothy Brian Moore, O.D.
• Willa Fung Moore, M.D.
• Megan Marie Moors
• Anne Marie Moos, APRN
• Kamilah Moppins

• Nurse Practitioner in Reno, NV
• Providers in Reno, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2015; 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.