Individual provider Active NPI

Heather Moosbrugger, RN

  • General Practice Registered Nurse
  • Dallas, TX
National Provider Identifier
1861287617
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice Registered NurseTaxonomy code 163WG0000X
License
717799 Issued in TX
Practice address
1015 N Carroll Ave Ste 2000
Dallas, TX 75204-6607
Phone
(214) 504-3486
NPI assigned
Apr 11, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 717799 TX Primary

Addresses

Primary practice location

1015 N Carroll Ave Ste 2000
Dallas, TX 75204-6607

Mailing address

3024 FM 859
Edgewood, TX 75117-3820
Phone (469) 834-7978

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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
717799TXMDGeneral Practice Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1744329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1861287617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 FM 859",
            "city": "EDGEWOOD",
            "state": "TX",
            "postal_code": "751173820",
            "telephone_number": "469-834-7978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1015 N CARROLL AVE STE 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752046607",
            "telephone_number": "214-504-3486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOSBRUGGER",
        "first_name": "HEATHER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-11",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "TX",
            "license": "717799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2025; 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.