NPIMap

Individual provider Active NPI

Jeannine M. Moss, FNP

  • Adult Health Nurse Practitioner
  • Richmond, VA
National Provider Identifier
1962622654
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
0017137123 Issued in VA
Practice address
5855 Bremo Rd
Suite 506
Richmond, VA 23226-1926
Phone
(804) 285-3225
Fax
(804) 285-0360
NPI assigned
Apr 26, 2007
Last updated
Mar 12, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

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 0017137123 VA Primary

Addresses

Primary practice location

5855 Bremo Rd
Suite 506
Richmond, VA 23226-1926

Mailing address

5855 Bremo Rd
Suite 506
Richmond, VA 23226-1926
Phone (804) 285-3225

Other identifiers 1

IdentifierTypeStateIssuer
C06695OtherVAGROUP PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080826000356 VA Practitioner - Nurse Practitioner 7911072947 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1510 N 28TH St
Richmond, VA 23223-5311

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0017137123VAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bon Secours St Marys Hospital of Richmond LLC CurrentSince Mar 24, 2020 Accepting new patients
Bon Secours St. Francis Medical Center LLC Current Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St Mary's Hospital of Richmond LLC CurrentSince Mar 24, 2020 Accepting new patients
Bon Secours St. Francis Medical Center LLC CurrentSince Mar 24, 2020 Accepting new patients
Bon Secours Medical Group Richmond Specialty Care LLC CurrentSince Jan 1, 2020 Accepting new patients
Bon Secours St. Francis Medical Center LLC CurrentSince Mar 24, 2020 Accepting new patients
Bon Secours St. Mary's Hospital of Richmond LLC Current Accepting new patients
Bon Secours-Virginia Healthsource Inc Past Accepting new patients
Bon Secours-Virginia Healthsource Inc Past Accepting new patients

Locations

611 Watkins Centre Pkwy
Ste 250
Midlothian, VA 23114
Phone (804) 423-8470

1510 N 28th St
Ste 110
Richmond, VA 23223
Phone (804) 545-2304

5855 Bremo Rd
Ste 306
Richmond, VA 23226
Phone (804) 287-7644

5855 Bremo Rd
Ste 506
Richmond, VA 23226
Phone (804) 285-3225

8580 Magellan Pkwy
Richmond, VA 23227
Phone (804) 627-5462

1362 Tappahannock Blvd
Tappahannock, VA 22560
Phone (804) 443-5378

Interoperability endpoints

  • Direct secure messaging: jmoss1153988@direct.bsmhealth.org

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331510400000",
    "number": "1962622654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD",
            "address_2": "SUITE 506",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261926",
            "telephone_number": "804-285-3225",
            "fax_number": "804-285-0360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5855 BREMO RD",
            "address_2": "SUITE 506",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232261926",
            "telephone_number": "804-285-3225",
            "fax_number": "804-285-0360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "JEANNINE",
        "middle_name": "M.",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2012-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0017137123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP PTAN",
            "identifier": "C06695",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.