Active NPI
Angela Ryland Mooers
- Social Worker
- Gulfport, MS
National Provider Identifier
1487287751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- M3404
- Practice address
- 1600 Broad Ave
Gulfport, MS 39501-3603 - Phone
- (228) 863-1132
- Fax
- (228) 865-1700
- NPI assigned
- Feb 14, 2020
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | M3404 | MS | Primary |
Addresses
Primary practice location
1600 Broad Ave
Gulfport, MS 39501-3603
Mailing address
1600 Broad Ave
Gulfport, MS 39501-3603
Phone (228) 860-6113
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M3404 | MS | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581638400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581638400000",
"number": "1487287751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 BROAD AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395013603",
"telephone_number": "228-860-6113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 BROAD AVE",
"city": "GULFPORT",
"state": "MS",
"postal_code": "395013603",
"telephone_number": "228-863-1132",
"fax_number": "228-865-1700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOOERS",
"first_name": "ANGELA",
"middle_name": "RYLAND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-14",
"last_updated": "2020-02-14",
"certification_date": "2020-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MS",
"license": "M3404",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gulfport, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.