Individual provider Active NPI

Sherry Rayne Moya, FNP-BC

  • Family Nurse Practitioner
  • Roswell, NM
National Provider Identifier
1922264902
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R67236 Issued in NM
Practice address
300 W Country Club Rd Ste 230
Roswell, NM 88201-5240
Phone
(575) 622-1411
Fax
(575) 624-5630
NPI assigned
Jul 30, 2008
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN173415 GA
Family Nurse Practitioner 363LF0000X R67236 NM Primary

Addresses

Primary practice location

300 W Country Club Rd Ste 230
Roswell, NM 88201-5240

Mailing address

300 W Country Club Rd Ste 230
Roswell, NM 88201-5240
Phone (575) 622-1411

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sherry.moya.1@1610.direct.athenahealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090408000683 NM Practitioner - Nurse Practitioner 6204999626 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R67236NMMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nes Arizona Inc CurrentSince Jul 1, 2023 Accepting new patients
Las Cruces HB Medical Services LLC CurrentSince Nov 1, 2024 Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients
Aylo Health, LLC Past Accepting new patients

Locations

2430 W Pierce St
Carlsbad, NM 88220
Phone (505) 887-4100

4311 E Lohman Ave
Las Cruces, NM 88011
Phone (505) 556-6800

405 W Country Club Rd
Roswell, NM 88201
Phone (505) 622-8170

Interoperability endpoints

  • Direct secure messaging: sherry.moya.1@1610.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1217376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1922264902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W COUNTRY CLUB RD STE 230",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015240",
            "telephone_number": "575-622-1411",
            "fax_number": "575-624-5630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W COUNTRY CLUB RD STE 230",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882015240",
            "telephone_number": "575-622-1411",
            "fax_number": "575-624-5630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYA",
        "first_name": "SHERRY",
        "middle_name": "RAYNE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-30",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN173415",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NM",
            "license": "R67236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sherry.moya.1@1610.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "AMD Direct Address",
            "address_1": "300 W Country Club Rd Ste 230",
            "city": "Roswell",
            "state": "NM",
            "country_code": "US",
            "postal_code": "882015240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roswell, NM

Sources for this page

Verify at the official NPI Registry.