Active NPI
Sharon Moehle, ED,S.
- Psychologist
- Town and Country, MO
National Provider Identifier
1609090745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY0178
- Practice address
- 266 Lamp and Lantern VLG
Town and Country, MO 63017-8209 - Phone
- (636) 227-4949
- Fax
- (636) 779-1456
- NPI assigned
- Apr 12, 2007
- Last updated
- Jul 30, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY0178 | MO | Primary |
Addresses
Primary practice location
266 Lamp and Lantern VLG
Town and Country, MO 63017-8209
Mailing address
266 Lamp and Lantern VLG
Town and Country, MO 63017-8209
Phone (636) 227-4949
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000010003974 | Other | ID | REGENCE |
| 481086633 | Other | ID | TAX IDENTIFICATON |
| X5960 | Other | ID | BLUE CROSS |
| 805997100 | Medicaid | ID |
Other names 1
- Sharon Moehle
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 |
|---|---|---|---|
| PY0178 | MO | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1609090745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "266 LAMP AND LANTERN VLG",
"city": "TOWN AND COUNTRY",
"state": "MO",
"postal_code": "630178209",
"telephone_number": "636-227-4949",
"fax_number": "636-779-1456"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "266 LAMP AND LANTERN VLG",
"city": "TOWN AND COUNTRY",
"state": "MO",
"postal_code": "630178209",
"telephone_number": "636-227-4949",
"fax_number": "636-779-1456"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOEHLE",
"first_name": "SHARON",
"credential": "ED,S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "PY0178",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "REGENCE",
"identifier": "000010003974",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX IDENTIFICATON",
"identifier": "481086633",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "X5960",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805997100",
"state": "ID"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "SHARON",
"last_name": "MOEHLE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Town and Country, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.