Individual provider Active NPI

Sherrie Ann Moseler, R.N.

  • Administrator Registered Nurse
  • Traverse City, MI
National Provider Identifier
1669719456
Registry record updated Jan 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
4704196186 Issued in MI
Practice address
105 Hall St
Suite D
Traverse City, MI 49684-2288
Phone
(231) 935-4388
Fax
(231) 995-7900
NPI assigned
Jan 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 4704196186 MI Primary

Addresses

Primary practice location

105 Hall St
Suite D
Traverse City, MI 49684-2288

Mailing address

105 Hall St
Suite D
Traverse City, MI 49684-2288
Phone (231) 935-4388

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
4704196186MIMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Lakes Community Mental Health Authority Past Accepting new patients

Organizations & group practices 1

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": "1358121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1669719456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 HALL ST",
            "address_2": "SUITE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842288",
            "telephone_number": "231-935-4388",
            "fax_number": "231-995-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 HALL ST",
            "address_2": "SUITE D",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842288",
            "telephone_number": "231-935-4388",
            "fax_number": "231-995-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSELER",
        "first_name": "SHERRIE",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "R.N.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-14",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "MI",
            "license": "4704196186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.