Individual provider Active NPI

Kristine Moss

  • Social Worker
  • Manheim, PA
National Provider Identifier
1861275281
Registry record updated Sep 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW140189 Issued in PA
Practice address
903 S Chiques Rd Ste J
Manheim, PA 17545-9195
Phone
(717) 220-5252
Fax
(717) 389-3370
NPI assigned
Aug 17, 2023
Last updated
Sep 15, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW140189 PA Primary

Addresses

Primary practice location

903 S Chiques Rd Ste J
Manheim, PA 17545-9195

Mailing address

903 S Chiques Rd Ste J
Manheim, PA 17545-9195
Phone (717) 220-5252

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
SW140189PAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Journey Family Center Social Worker CurrentSince Sep 17, 2023 Accepting new patients
The Behavioral Health and Wellness Academy Social Worker PastSince Aug 1, 2023 Accepting new patients

Locations

903 S Chiques Rd
Ste J
Manheim, PA 17545
Phone (717) 220-5252

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694736000000",
    "number": "1861275281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 S CHIQUES RD STE J",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459195",
            "telephone_number": "717-220-5252",
            "fax_number": "717-389-3370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 S CHIQUES RD STE J",
            "city": "MANHEIM",
            "state": "PA",
            "postal_code": "175459195",
            "telephone_number": "717-220-5252",
            "fax_number": "717-389-3370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "KRISTINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-09-15",
        "certification_date": "2023-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "PA",
            "license": "SW140189",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manheim, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.