Active NPI
Tabitha Wanjiru Moche, NP-C
- Adult Health Nurse Practitioner
- Bristol, CT
National Provider Identifier
1942504451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 7256
- 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
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 |
|---|---|---|---|---|
| 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.
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7256 | CT | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| G&G Healthcare, PC | Past | Accepting new patients |
Interoperability endpoints
- 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.
-
- Family Medicine Physician
- Cerro Gordo, NC
- NPI 1205184694
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.