Individual provider Active NPI

Danielle Mooshol, DPM

  • Foot & Ankle Surgery Podiatrist
  • Daytona Beach, FL
National Provider Identifier
1689021578
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X
License
PO4416 Issued in FL
Practice address
1890 Lpga Blvd Ste 230
Daytona Beach, FL 32117-7131
Phone
(386) 274-3336
NPI assigned
May 20, 2016
Last updated
Oct 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PO61045806 WA
Primary Podiatric Medicine Podiatrist 213EP1101X PO230 HI
Sports Medicine Podiatrist 213ES0000X PO230 HI
Foot & Ankle Surgery Podiatrist 213ES0103X PO230 HI
Foot & Ankle Surgery Podiatrist 213ES0103X PO4416 FL Primary

Addresses

Primary practice location

1890 Lpga Blvd Ste 230
Daytona Beach, FL 32117-7131

Mailing address

1890 Lpga Blvd Ste 230
Daytona Beach, FL 32117-7131
Phone (386) 274-3336

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PO230HIMDPrimary Podiatric Medicine Podiatrist

NPI Registry JSON

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666742400000",
    "number": "1689021578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 230",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-274-3336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 LPGA BLVD STE 230",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321177131",
            "telephone_number": "386-274-3336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSHOL",
        "first_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-20",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO61045806",
            "primary": false
        },
        {
            "code": "213EP1101X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Primary Podiatric Medicine",
            "state": "HI",
            "license": "PO230",
            "primary": false
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "HI",
            "license": "PO230",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "HI",
            "license": "PO230",
            "primary": false
        },
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "FL",
            "license": "PO4416",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Daytona Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.