Individual provider Active NPI

Jean Renee Moszer, LPN

  • Licensed Practical Nurse
  • Fergus Falls, MN
National Provider Identifier
1861671950
Registry record updated Oct 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
L0653130 Issued in MN
Practice address
106 North 4TH Avenue
Fergus Falls, MN 56537-1034
Phone
(218) 998-3778
Fax
(218) 998-3187
NPI assigned
Oct 25, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X L0653130 MN Primary
Licensed Practical Nurse 164W00000X L11719 ND

Addresses

Primary practice location

106 North 4TH Avenue
Fergus Falls, MN 56537-1034

Mailing address

3320 35 Ave S
#204
Fargo, ND 58104-5130
Phone (701) 729-1532

Other names 1

  • Mrs. Jean Renee Odland Former name

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
L0653130MNMDLicensed Practical Nurse
L11719NDMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
CK Home Health Care Inc. Past Accepting new patients
CK Home Health Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1193270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193270400000",
    "number": "1861671950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 35 AVE S",
            "address_2": "#204",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581045130",
            "telephone_number": "701-729-1532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 NORTH 4TH AVENUE",
            "city": "FERGUS FALLS",
            "state": "MN",
            "postal_code": "565371034",
            "telephone_number": "218-998-3778",
            "fax_number": "218-998-3187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSZER",
        "first_name": "JEAN",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-25",
        "last_updated": "2007-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MN",
            "license": "L0653130",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "ND",
            "license": "L11719",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEAN",
            "last_name": "ODLAND",
            "middle_name": "RENEE",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fergus Falls, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.