Active NPI
Andrea L Moushigian, NP
- Nurse Practitioner
- Clovis, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 15837
- Practice address
- 681 Medical Center Dr W
Suite 101
Clovis, CA 93611-6803 - Phone
- (559) 323-9300
- NPI assigned
- Jun 30, 2006
- Last updated
- Oct 31, 2007
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 15837 | CA | Primary |
Addresses
Primary practice location
681 Medical Center Dr W
Suite 101
Clovis, CA 93611-6803
Mailing address
9036 N Recreation Ave
Fresno, CA 93720-4139
Phone (559) 307-3152
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 243023 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15837 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cep America - California | Current | Accepting new patients | |
| Central Calif ENT Medical Group | Current | Accepting new patients | |
| Cep America - California | Current | Accepting new patients | |
| Cep America-California | Current | Accepting new patients | |
| Michael L Illingworth, MD Inc | Past | Accepting new patients |
Locations
2755 Herndon Ave
Clovis, CA 93611
Phone (559) 323-4000
2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777
1351 E Spruce Ave
Fresno, CA 93720
Phone (559) 432-3303
1250 E Almond Ave
Madera, CA 93637
Phone (559) 675-5501
1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663
4445 Magnolia Ave
Riverside, CA 92501
Phone (800) 498-7156
Organizations & group practices 5
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151625600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193788800000",
"number": "1619906989",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9036 N RECREATION AVE",
"city": "FRESNO",
"state": "CA",
"postal_code": "937204139",
"telephone_number": "559-307-3152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "681 MEDICAL CENTER DR W",
"address_2": "SUITE 101",
"city": "CLOVIS",
"state": "CA",
"postal_code": "936116803",
"telephone_number": "559-323-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUSHIGIAN",
"first_name": "ANDREA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-30",
"last_updated": "2007-10-31",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "15837",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "243023",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Clovis, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.