Traci M. Moreland, MPA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50-00-1745 Issued in OH

Practice address

1455 Harrison Ave NW
Suite 105
Canton, OH 44708-2621

Phone

(330) 453-9993

Fax

(330) 453-9996

NPI assigned

Feb 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216252800000",
    "number": "1891836045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 HARRISON AVE NW",
            "address_2": "SUITE 105",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082621",
            "telephone_number": "330-453-9993",
            "fax_number": "330-453-9996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 HARRISON AVE NW",
            "address_2": "SUITE 105",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082621",
            "telephone_number": "330-453-9993",
            "fax_number": "330-453-9996"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORELAND",
        "first_name": "TRACI",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "MPA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2008-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50-00-1745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4169790001",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• More Like Home LLC
• Alisha Lynn Morefield
• Christine Morehead, LPC
• Darriona Reshay Moreland
• Sanathan Moreland
• Mary Ann Morena, RN BSN
• Diane Marie Moreno Zerby, LISW-S
• Berenice Moreno, QMHS
• Brigitta A Moresea, M.D.
• George A Moresea, MD

• Physician Assistant in Canton, OH
• Providers in Canton, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2008; 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.