Active NPI
Sandra Marie Mooney
- Women's Health Nurse Practitioner
- Columbia, MD
National Provider Identifier
1710977699
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- R03707
- Practice address
- 11065 Little Patuxent Pkwy
Columbia, MD 21044-2998 - Phone
- (410) 730-5700
- Fax
- (410) 964-3231
- NPI assigned
- Oct 24, 2005
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Women's Health Nurse Practitioner | 363LW0102X | R03707 | MD | Primary |
Addresses
Primary practice location
11065 Little Patuxent Pkwy
Columbia, MD 21044-2998
Mailing address
7925 Anfred Dr
Laurel, MD 20723-1136
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| R030707 | Other | MD | RN |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R03707 | MD | MD | Women's Health Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1710977699",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7925 ANFRED DR",
"city": "LAUREL",
"state": "MD",
"postal_code": "207231136"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11065 LITTLE PATUXENT PKWY",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210442998",
"telephone_number": "410-730-5700",
"fax_number": "410-964-3231"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOONEY",
"first_name": "SANDRA",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-24",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "MD",
"license": "R03707",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RN",
"identifier": "R030707",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbia, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.