Individual provider Active NPI

Moneka Angilene Patterson, APRN

  • Family Nurse Practitioner
  • Atlanta, GA
National Provider Identifier
1659779809
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN269126 Issued in GA
Practice address
3637 Peachtree Rd NE
Atlanta, GA 30319-1252
Phone
(404) 926-3541
NPI assigned
Dec 19, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN269126 GA Primary
Family Nurse Practitioner 363LF0000X 19215 SC

Addresses

Primary practice location

3637 Peachtree Rd NE
Atlanta, GA 30319-1252

Mailing address

3450 Blair Cir NE Unit 4210
Brookhaven, GA 30319-2266
Phone (843) 617-3028

Other practice location 1

201 Cashua St
Darlington, SC 29532-3301
Phone (843) 393-7452

Other identifiers 1

IdentifierTypeStateIssuer
NP3147MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, TX, AZ, NV4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230905001380 CA Practitioner - Nurse Practitioner 7113247578 Reassigns benefits to 1 organization
I20230929002321 TX Practitioner - Nurse Practitioner 7113247578 Reassigns benefits to 1 organization
I20230929002719 AZ Practitioner - Nurse Practitioner 7113247578 Reassigns benefits to 1 organization
I20231102001030 NV Practitioner - Nurse Practitioner 7113247578 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN269126GAMDFamily Nurse Practitioner
19215SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Larson MD PC CurrentSince Jul 4, 2023 Accepting new patients
Cedars-Sinai Medical Care Foundation Past Accepting new patients
Central Texas Holistic Care PLLC Family PastSince Aug 25, 2024 Accepting new patients

Locations

3000 N Litchfield Rd
Ste 120
Goodyear, AZ 85395
Phone (623) 282-4078

2505 Anthem Village Dr
Ste E162
Henderson, NV 89052

3185 Saint Rose Pkwy
Ste 330
Henderson, NV 89052
Phone (702) 735-5075

2505 Anthem Village Dr
Ste F162
Henderson, NV 89052

2505 Anthem Village Dr
Ste F
Henderson, NV 89052

701 N Green Valley Pkwy
Ste 213
Henderson, NV 89074

2025 Memory Ln
Ste 300
Harker Heights, TX 76548
Phone (254) 987-8802

Interoperability endpoints

  • Direct secure messaging: moneka.patterson@49412312072196.direct.elationemr.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1418947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1659779809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 BLAIR CIR NE UNIT 4210",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192266",
            "telephone_number": "843-617-3028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3637 PEACHTREE RD NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303191252",
            "telephone_number": "404-926-3541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "201 Cashua St",
            "address_purpose": "LOCATION",
            "city": "Darlington",
            "state": "SC",
            "postal_code": "295323301",
            "country_code": "US",
            "telephone_number": "843-393-7452",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MONEKA",
        "middle_name": "ANGILENE",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-19",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN269126",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "19215",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP3147",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

Verify at the official NPI Registry.