Individual provider Active NPI

Julie D Moorehead

  • Pediatric Nurse Practitioner
  • Morgantown, WV
National Provider Identifier
1750531349
Registry record updated Feb 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
APRN62515 Issued in WV
Practice address
1 Medical Center Dr
Morgantown, WV 26506-1200
Phone
(855) 988-2273
NPI assigned
Sep 19, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 62515 WV
Pediatric Nurse Practitioner 363LP0200X APRN62515 WV Primary

Addresses

Primary practice location

1 Medical Center Dr
Morgantown, WV 26506-1200

Mailing address

1 Medical Center Dr
Morgantown, WV 26506-1200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20081203000834 WV Practitioner - Nurse Practitioner 9931260338 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
62515WVMDPediatric Nurse Practitioner
APRN62515WVMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Education Building CurrentSince Aug 30, 2010 Accepting new patients
West Virginia University Medical Corporation CurrentSince Aug 30, 2010 Accepting new patients
West Virginia University Medical Corporation Current Accepting new patients

Locations

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

Organizations & group practices 3

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": "1221782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1750531349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "855-988-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOREHEAD",
        "first_name": "JULIE",
        "middle_name": "D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-19",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "62515",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "WV",
            "license": "APRN62515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.