Individual provider Active NPI

Teresa Mooney, NP-C

  • Nurse Practitioner
  • Bristol, TN
National Provider Identifier
1467932533
Registry record updated Dec 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
APRN82500-NP-C Issued in WV
Practice address
324 Leslie CT
Bristol, TN 37620
Phone
(423) 646-2864
NPI assigned
Aug 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X APRN82500-NP-C WV Primary

Addresses

Primary practice location

324 Leslie CT
Bristol, TN 37620

Mailing address

310 Maryland Ave
Beckley, WV 25801-4226
Phone (304) 228-9158

Other practice location 1

310 Maryland Ave
Beckley, WV 25801-4226
Phone (304) 228-9158

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200113002442 WV Practitioner - Nurse Practitioner 9537594957 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APRN82500-NP-CWVMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Regional Healthcare, Inc CurrentSince Nov 1, 2019 Accepting new patients
Appalachian Regional Healthcare, Inc Nurse Practitioner CurrentSince Nov 1, 2019 Accepting new patients

Locations

100 Airport Gardens Rd
Hazard, KY 41701
Phone (606) 487-7503

1828 Harper Rd
Beckley, WV 25801
Phone (304) 253-4004

306 Stanaford Rd
Beckley, WV 25801
Phone (304) 255-3373

250 Stanaford Rd
Beckley, WV 25801
Phone (304) 252-7331

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": "1534464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545609600000",
    "number": "1467932533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MARYLAND AVE",
            "city": "BECKLEY",
            "state": "WV",
            "postal_code": "258014226",
            "telephone_number": "304-228-9158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 LESLIE CT",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "37620",
            "telephone_number": "423-646-2864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "310 Maryland Ave",
            "address_purpose": "LOCATION",
            "city": "Beckley",
            "state": "WV",
            "postal_code": "258014226",
            "country_code": "US",
            "telephone_number": "304-228-9158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOONEY",
        "first_name": "TERESA",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-17",
        "last_updated": "2018-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WV",
            "license": "APRN82500-NP-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.