Jacqueline Lynn Moen, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

29160 Issued in MT

Practice address

300 Garnet Way
Warm Springs, MT 59756

Phone

(406) 693-7000

NPI assigned

Oct 22, 2013

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• State of Montana

  • Skilled Nursing Facility
  • Columbia Falls, MT
  • NPI 1356351183
  NPD (past)

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

{
    "created_epoch": "1382400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382400000000",
    "number": "1801224209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 RISING SUN LN",
            "city": "CASCADE",
            "state": "MT",
            "postal_code": "594218025",
            "telephone_number": "406-390-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 GARNET WAY",
            "city": "WARM SPRINGS",
            "state": "MT",
            "postal_code": "59756",
            "telephone_number": "406-693-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOEN",
        "first_name": "JACQUELINE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-22",
        "last_updated": "2013-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "29160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas D. Horne, PHARM D.
• Michelle Linn Huffines, MSN, APRN, FNP-BC
• Heather Lynn Kaleva, PMHNP-BC
• Gary D Lord, MD
• Richard H Miller, MD
• Anna Christine Napoli, DNP
• Jeri Payne, APRN
• Jeff S. Pflug, MA, L.A.C.
• Scott S Piranian, MD
• Nora Ann Schillo, APRN

• Psychiatric/Mental Health Nurse Practitioner in Warm Springs, MT
• Providers in Warm Springs, MT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2013; 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.