Sandra L. Moser, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

125899 Issued in MO

Practice address

815 E Broadway St
Brunswick, MO 65236-1468

Phone

(660) 548-3161

Fax

(660) 831-3361

NPI assigned

Jul 3, 2006

Sex

Female

Sole proprietor

No

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 13, 2016.

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1669402004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "815 E BROADWAY ST",
            "city": "BRUNSWICK",
            "state": "MO",
            "postal_code": "652361468",
            "telephone_number": "660-548-3161",
            "fax_number": "660-831-3361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "815 E BROADWAY ST",
            "city": "BRUNSWICK",
            "state": "MO",
            "postal_code": "652361468",
            "telephone_number": "660-548-3161",
            "fax_number": "660-831-3361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSER",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "125899",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "429676216",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MA0185010",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Brunswick, MO
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.