Debra Giuliana Moore-Zierow, FNP-BC, PMHNP-BC
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Mathews, VA
NPI 1821592676 · NPPES record last updated Mar 7, 2023
Key facts
- NPI
- 1821592676
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 0024165298 (VA)
- Practice address
- 75 Main St
Suite a
Mathews, VA 23109 - Phone
- (804) 725-3041
- Fax
- (804) 725-3510
- NPI assigned
- Mar 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- The Changing Tide Body, Mind and Spirit P.C.
Practice addresses (Care Compare)
75 A Main St
Mathews, VA 23109-5115
Phone (804) 725-3041
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190508001099 | VA | Practitioner - Nurse Practitioner | 5193067304 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0001135008 | VA | MD | Registered Nurse |
| 0024165298 | VA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Changing Tide Body, Mind & Spirit P.C. | Psychiatric/Mental Health | Current |
Accepting new patients |
| The Changing Tide Body Mind & Spirit PC Dba I Choose Life Inc. | Psychiatric/Mental Health | Current |
Accepting new patients |
Locations
75 Main St
Ste A
Mathews, VA 23109
Phone (804) 725-3041
75 Main St
#A
Mathews, VA 23109
Phone (804) 725-3041
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 0001135008 | VA | |
| Family Nurse Practitioner | 363LF0000X | 0024165298 | VA | |
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 0024165298 | VA | Yes |
Addresses
Primary practice location
75 Main St
Suite a
Mathews, VA 23109
Mailing address
PO Box 327
Mathews, VA 23109-0327
Phone (804) 725-3041
Other practice location 1
324 Monticello Ave
Williamsburg, VA 23185-2834
Phone (757) 503-7917
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2018073749 | Other | VA | PMHNP CERTIFICATION : ANCC |
| 0017144661 | Other | VA | PRESCRIPTION AUTH. |
| 0001135008 | Other | VA | REGISTERED NURSE |
| 0370398 | Other | VA | FAMILY NURSE PRACTITIONER CERTIFICATION : ANCC |
| 0024165298 | Other | VA | NURSE PRACTITIONER |
Other providers in Mathews, VA
- Lynette R Glockner, Inc.
- Mathews County Public Schools
- Robert A May
- Middle Peninsula Medical Center Inc
- Kathryn Charles Miles
- Lisa Morse
- Ashley Murphy
- Patrick Henry Hospital, Inc.
- Peninsula Institute for Community Health Inc
- Raymond Joseph Porzio
All providers in Mathews, VA · Psychiatric/Mental Health Nurse Practitioner in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 7, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.