Cresfield Winslow Moody, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP2197 Issued in AZ

Practice address

463 S. Lake Powell Blvd
Page, AZ 86040-0790

Phone

(928) 645-0945

Fax

(925) 645-3254

NPI assigned

Apr 21, 2006

Last updated

Aug 27, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377561600000",
    "number": "1962468678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 790",
            "address_2": "463 S. LAKE POWELL BLVD",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400790",
            "telephone_number": "928-645-0945",
            "fax_number": "928-645-3254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "463 S. LAKE POWELL BLVD",
            "city": "PAGE",
            "state": "AZ",
            "postal_code": "860400790",
            "telephone_number": "928-645-0945",
            "fax_number": "925-645-3254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOODY",
        "first_name": "CRESFIELD",
        "middle_name": "WINSLOW",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2013-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "AP2197",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ELECTRONIC TRADING NUMBER",
            "identifier": "AZ07272",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "AZ158651",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "957152",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Theodore Martin
• Harold William Martindale, P.A.
• Clinton Charles McCormick, PHARM.D.
• Maria Dorothea McHenry, SLPA
• Jeff McIntyre, MS COUNSELOR, LPC
• Faith Mooney, M.ED.
• Michael Jason Moore, D.C.
• Fe Damarys Murray, M.S., CCC-SLP
• My Kidney Care Center, LLC
• Seth Curtis Nolan, APRN-RNP

• Family Nurse Practitioner in Page, AZ
• Providers in Page, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2013; 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.