Individual provider Active NPI

Cheryl Elizabeth Mosley, NP-C

  • Family Nurse Practitioner
  • El Centro, CA
National Provider Identifier
1770614489
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200650151NP Issued in OR
Practice address
651 Wake Ave Ste a
El Centro, CA 92243
Phone
(760) 352-2257
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 200650151NP OR Primary

Addresses

Primary practice location

651 Wake Ave Ste a
El Centro, CA 92243

Mailing address

3120 NE 158TH Ave
Portland, OR 97230-5111
Phone (971) 269-5331

Other practice location 1

2501 NW 229th AVE
Ms; Ra3-113
Hillsboro, OR 97124
Phone (971) 214-8422

Other names 1

  • Cheryl Elizabeth Taylor Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20191122002412 CA Practitioner - Nurse Practitioner 6507054475 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
21501CAMDOccupational Therapist
200650151NPORMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Medical Organization, a Medical Group Inc. CurrentSince Sep 9, 2019 Accepting new patients

Locations

191 S Buena Vista St
Ste 200
Burbank, CA 91505
Phone (818) 887-2671

8510 Balboa Blvd
Ste 150
Northridge, CA 91325
Phone (818) 637-2000

Interoperability endpoints

  • Direct secure messaging: cheryl.mosley.p1@direct.lakeside.nextgenshare.com

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": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1770614489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3120 NE 158TH AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305111",
            "telephone_number": "971-269-5331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "651 WAKE AVE STE A",
            "city": "EL CENTRO",
            "state": "CA",
            "postal_code": "92243",
            "telephone_number": "760-352-2257"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2501 NW 229th AVE",
            "address_2": "MS; RA3-113",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "97124",
            "country_code": "US",
            "telephone_number": "971-214-8422",
            "fax_number": "971-214-8607",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSLEY",
        "first_name": "CHERYL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "200650151NP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHERYL",
            "last_name": "TAYLOR",
            "middle_name": "ELIZABETH",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in El Centro, CA

Sources for this page

Verify at the official NPI Registry.