Moses Momo
Individual provider Active NPI Nurse's Aide · Mandan, ND
NPI 1609449735 · NPPES record last updated Jul 16, 2021
Key facts
- NPI
- 1609449735
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse's Aide 376K00000X
- License
- 68227 (ND)
- Practice address
- 2108 Eastbay Dr SE
Mandan, ND 58554-6271 - Phone
- (646) 251-7420
- NPI assigned
- Jul 16, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68227 | ND | MD | Nurse's Aide |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Drove Rides Technology LLC | Current |
Accepting new patients | |
| Dakota Premier Home Care | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse's Aide | 376K00000X | 68227 | ND | Yes |
Addresses
Primary practice location
2108 Eastbay Dr SE
Mandan, ND 58554-6271
Mailing address
2108 Eastbay Dr SE
Mandan, ND 58554-6271
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | dakotapremierhomecarellc.com | Direct | Dakota Premier Home Care LLC |
Other providers in Mandan, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.