Individual provider Active NPI

Glenda Moses, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1962556894
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN0000085495 Issued in TN
Practice address
1325 Eastmoreland Ave Ste 245
Memphis, TN 38104-3591
Phone
(901) 729-3700
Fax
(901) 729-3750
NPI assigned
Jan 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN0000085495 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave Ste 245
Memphis, TN 38104-3591

Mailing address

1325 Eastmoreland Ave Ste 245
Memphis, TN 38104-3591
Phone (901) 729-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20120305000378 TN Practitioner - Nurse Practitioner 4486821337 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN0000085495TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Meharry Health Network, PC CurrentSince Jul 7, 2022 Accepting new patients
Meharry Health Network, PC CurrentSince Jul 7, 2022 Accepting new patients
Nashville Cares Past Accepting new patients

Locations

8400 NW 33rd St
Ste 201
Doral, FL 33122
Phone (786) 882-2869

438 N Cleveland St
Memphis, TN 38104
Phone (866) 364-8944

1200 E Raines Rd
Ste 101
Memphis, TN 38116
Phone (663) 648-9448

Interoperability endpoints

  • Direct secure messaging: glenda.moses@wwmp.eclinicaldirectplus.com
  • Direct secure messaging: glenda.moses.1@20088.direct.athenahealth.com

Organizations & group practices 3

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": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962556894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 245",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043591",
            "telephone_number": "901-729-3700",
            "fax_number": "901-729-3750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE STE 245",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043591",
            "telephone_number": "901-729-3700",
            "fax_number": "901-729-3750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSES",
        "first_name": "GLENDA",
        "name_prefix": "Mrs.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "RN0000085495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.