Jessie Dawn Moodie-Shepherd, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

F336664 Issued in NY

Practice address

1 Penn PLZ
8TH Floor
New York, NY 10119-0002

Phone

(646) 761-1725

NPI assigned

Jun 30, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Genesis Medical Health PC

  • General Practice Physician
  • Spring Valley, NY
  • NPI 1295043099
  Medicare reassignment NPD

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438041600000",
    "number": "1578850376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "646-761-1725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PENN PLZ",
            "address_2": "8TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101190002",
            "telephone_number": "646-761-1725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODIE-SHEPHERD",
        "first_name": "JESSIE",
        "middle_name": "DAWN",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-30",
        "last_updated": "2015-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winifred Anne Montuori, DDS
• Lynn Barbara Montz, M.D.
• Nilfa Monzon
• Tracy-Ann Moo, M.D.
• Sahana Moodabagil, PSYD
• Christopher Wayne Moody, CRNA
• Hasan Moody, LMSW
• Lisa Moody
• Mandolin Moody
• Melanee Moody

• Family Nurse Practitioner in New York, NY
• Providers in New York, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.