Michelle Loman Moudry, PH.D.

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

Practice address

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522

Phone

(414) 805-9248

NPI assigned

Jul 14, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Michelle Loman Professional name

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mlomanmoudry17264@direct.chw.org

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.

• The Medical College of Wisconsin, Inc.

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1699720086
  Medicare reassignment
• Children'S Specialty Group, Inc.

  • Pediatrics Physician
  • Milwaukee, WI
  • NPI 1942970405
  NPD (past)

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

{
    "created_epoch": "1405296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409270400000",
    "number": "1962819706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9200 W WISCONSIN AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532263522",
            "telephone_number": "414-805-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOMAN MOUDRY",
        "first_name": "MICHELLE",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-14",
        "last_updated": "2014-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "WI",
            "license": null,
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WI",
            "license": "3182-57",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LOMAN",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Robert Loiben, M.D.
• William Lois, DPT
• Sarah Charlotte Loizzo, MD
• James Patrick Lokken, PHARMD
• Lola'S New Beginnings
• Dawn R Lombard, PAC
• Emily Elizabeth Lombard, D.O.
• Danica Michelle Lombardi Gastier, OTR/L
• Jonathon Robert Lombardi
• Matthew Loncki, PTA

• Clinical Neuropsychologist in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Clinical Neuropsychologist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.