Individual provider Active NPI

Gussie Annett Moneymaker, APN

  • Women's Health Nurse Practitioner
  • Searcy, AR
National Provider Identifier
1912910050
Registry record updated Sep 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
A01184 ANP Issued in AR
Practice address
112 Brantley Rd
Searcy, AR 72143-8315
Phone
(501) 268-6102
Fax
(501) 268-4445
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X A01184 ANP AR Primary

Addresses

Primary practice location

112 Brantley Rd
Searcy, AR 72143-8315

Mailing address

105 Knollwood Dr
Searcy, AR 72143-8679
Phone (501) 207-2738

Other identifiers 1

IdentifierTypeStateIssuer
440109501OtherARMEDICAID PRESCRIBER ID

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
A01184 ANPARMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Arkansas Past Accepting new patients
State of Arkansas 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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347840000000",
    "number": "1912910050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 KNOLLWOOD DR",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721438679",
            "telephone_number": "501-207-2738",
            "fax_number": "501-268-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 BRANTLEY RD",
            "city": "SEARCY",
            "state": "AR",
            "postal_code": "721438315",
            "telephone_number": "501-268-6102",
            "fax_number": "501-268-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MONEYMAKER",
        "first_name": "GUSSIE",
        "middle_name": "ANNETT",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2012-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "AR",
            "license": "A01184  ANP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID PRESCRIBER ID",
            "identifier": "440109501",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Searcy, AR

Sources for this page

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

Verify at the official NPI Registry.