Active NPI
Sania Joseph Moonnumackel
- Student in an Organized Health Care Education/Training Program
- Fort Worth, TX
National Provider Identifier
1649972365
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 900 8TH Ave
Fort Worth, TX 76104-3902 - Phone
- (817) 347-1140
- NPI assigned
- Mar 17, 2023
- 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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
900 8TH Ave
Fort Worth, TX 76104-3902
Mailing address
1607 Boone Hollow LN
Richmond, TX 77469-3763
Phone (425) 625-1995
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230804000112 | TX | Order and Referring Only - Internal Medicine | 4082075288 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1679011200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1679443200000",
"number": "1649972365",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1607 BOONE HOLLOW LN",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774693763",
"telephone_number": "425-625-1995"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 8TH AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761043902",
"telephone_number": "817-347-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOONNUMACKEL",
"first_name": "SANIA",
"middle_name": "JOSEPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-03-17",
"last_updated": "2023-03-22",
"certification_date": "2023-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.