Active NPI
Debbieanne Moeller, CPNP
- Pediatric Nurse Practitioner
- New Castle, CO
National Provider Identifier
1902967755
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- 83645
- Practice address
- 820 Castle Valley Blvd
Suite 204
New Castle, CO 81647-9480 - Phone
- (970) 984-3333
- Fax
- (970) 984-0293
- NPI assigned
- Dec 13, 2006
- Last updated
- Feb 27, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | 83645 | CO | Primary |
Addresses
Primary practice location
820 Castle Valley Blvd
Suite 204
New Castle, CO 81647-9480
Mailing address
820 Castle Valley Blvd
Suite 204
New Castle, CO 81647-9480
Phone (970) 984-3333
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 42200547 | Medicaid | CO |
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
- Certified Pediatric Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 83645 | CO | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Castle Valley Children's Clinic | Past | Accepting new patients | |
| Castle Valley Children's Clinic | Pediatrics | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Primary Care Clinic/Center
- Carbondale, CO
- NPI 1285282137
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330300800000",
"number": "1902967755",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 CASTLE VALLEY BLVD",
"address_2": "SUITE 204",
"city": "NEW CASTLE",
"state": "CO",
"postal_code": "816479480",
"telephone_number": "970-984-3333",
"fax_number": "970-984-0293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 CASTLE VALLEY BLVD",
"address_2": "SUITE 204",
"city": "NEW CASTLE",
"state": "CO",
"postal_code": "816479480",
"telephone_number": "970-984-3333",
"fax_number": "970-984-0293"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOELLER",
"first_name": "DEBBIEANNE",
"name_prefix": "Mrs.",
"credential": "CPNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2012-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "CO",
"license": "83645",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "42200547",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in New Castle, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.