NPIMap

Individual provider Active NPI

Moira E Kendra, NPC

  • Adult Health Nurse Practitioner
  • Summit, NJ
National Provider Identifier
1508062514
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
26NN08639300 Issued in NJ
Practice address
1 Springfield Ave
Suite 3a
Summit, NJ 07901-4055
Phone
(908) 934-0555
Fax
(908) 934-0556
NPI assigned
Jun 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 26NN08639300 NJ Primary

Addresses

Primary practice location

1 Springfield Ave
Suite 3a
Summit, NJ 07901-4055

Mailing address

1 Springfield Ave
Suite 3a
Summit, NJ 07901-4055
Phone (908) 934-0555

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
26NN08639300NJMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary & Allergy Associates, PA Past Accepting new patients
Summit Anesthesia Associates PA Past Accepting new patients

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508062514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 SPRINGFIELD AVE",
            "address_2": "SUITE 3A",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014055",
            "telephone_number": "908-934-0555",
            "fax_number": "908-934-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 SPRINGFIELD AVE",
            "address_2": "SUITE 3A",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079014055",
            "telephone_number": "908-934-0555",
            "fax_number": "908-934-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KENDRA",
        "first_name": "MOIRA",
        "middle_name": "E",
        "credential": "NPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NJ",
            "license": "26NN08639300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Summit, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.