Individual provider Active NPI

Anne Muthoni Mokonyama, CRNP

  • Family Nurse Practitioner
  • Phoenixville, PA
National Provider Identifier
1942864095
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP019868 Issued in PA
Practice address
140 Nutt Rd
Phoenixville, PA 19460-3900
Phone
(610) 983-1601
NPI assigned
Apr 24, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X SP019868 PA Primary

Addresses

Primary practice location

140 Nutt Rd
Phoenixville, PA 19460-3900

Mailing address

140 Nutt Rd
Phoenixville, PA 19460-3900
Phone (610) 983-1601

Other names 1

  • Anne Muthoni Waithera Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20260415003056 PA Practitioner - Nurse Practitioner 3779059902 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

415 W Golf Rd
Arlington Heights, IL 60005-3923

444 E Roosevelt Rd
Suite 256
Lombard, IL 60148-4630

726 Thornhill Dr
Collegeville, PA 19426-3955

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SP019868PAMDFamily Nurse Practitioner

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": "1556064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1942864095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 NUTT RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603900",
            "telephone_number": "610-983-1601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 NUTT RD",
            "city": "PHOENIXVILLE",
            "state": "PA",
            "postal_code": "194603900",
            "telephone_number": "610-983-1601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOKONYAMA",
        "first_name": "ANNE",
        "middle_name": "MUTHONI",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-24",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP019868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANNE",
            "last_name": "WAITHERA",
            "middle_name": "MUTHONI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Phoenixville, PA

Sources for this page

Verify at the official NPI Registry.