Individual provider Active NPI

Tabitha Wanjiru Moche, NP-C

  • Adult Health Nurse Practitioner
  • Bristol, CT
National Provider Identifier
1942504451
Registry record updated May 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
7256 Issued in CT
Practice address
23 Fair St
Bristol, CT 06010
Phone
(860) 589-2923
NPI assigned
Dec 28, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 7256 CT Primary

Addresses

Primary practice location

23 Fair St
Bristol, CT 06010

Mailing address

23 Fair St
Bristol, CT 06010-5531

Other practice location 1

9001 Digges Rd
Suite 107
Manassas, VA 20110-4421
Phone (703) 330-1112

Other practice location 2

23 Fair St
Bristol, CT 06010-5531
Phone (860) 589-2923

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
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
7256CTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
G&G Healthcare, PC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: tabitha.moche@145331296403460.direct.elationemr.com

Organizations & group practices 1

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": "1293494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559260800000",
    "number": "1942504451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 FAIR ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060105531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 FAIR ST",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "06010",
            "telephone_number": "860-589-2923"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9001 Digges Rd",
            "address_2": "Suite 107",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104421",
            "country_code": "US",
            "telephone_number": "703-330-1112",
            "fax_number": "703-330-3113",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23 Fair St",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "CT",
            "postal_code": "060105531",
            "country_code": "US",
            "telephone_number": "860-589-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOCHE",
        "first_name": "TABITHA",
        "middle_name": "WANJIRU",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-28",
        "last_updated": "2019-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "CT",
            "license": "7256",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2019; 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.