Jennifer L Moes, APRN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

APRN9461847 Issued in FL

Practice address

1454 Madison Ave W
Immokalee, FL 34142-2200

Phone

(239) 658-3707

NPI assigned

Jul 3, 2006

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Heart of Florida Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ocala, FL
  • NPI 1710923727
  Medicare reassignment NPD
• Heart of Florida Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Ocala, FL
  • NPI 1982248134
  NPD
• The Center for Progress and Excellence, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Fort Myers, FL
  • NPI 1861907339
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1720018211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 TECHSTER BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339664805",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 MADISON AVE W",
            "city": "IMMOKALEE",
            "state": "FL",
            "postal_code": "341422200",
            "telephone_number": "239-658-3707"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6360 Techster Blvd",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339664805",
            "country_code": "US",
            "telephone_number": "239-223-2751",
            "fax_number": "239-561-2933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOES",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "FL",
            "license": "APRN9461847",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "ARNP9461847",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023011900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angelique Melendez-Blanch, PSYD
• Jean Kesnold Mesidor, PHD
• Sandra Juanita Milan, MD
• Laverne Beal Miller, M.ED
• Serge Mistivar, D.O
• Perla Moran
• Katiuska Moreno, ARNP
• Joseph G Moyse
• Amy Niewald
• Ninis Kitchen Haitian Cuisine LLC

• Pediatric Nurse Practitioner in Immokalee, FL
• Providers in Immokalee, FL by specialty
• Pediatric Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.