Active NPI
Sandra A Mosby, RN, GNP-BS
- Gerontology Nurse Practitioner
- Tyler, TX
National Provider Identifier
1982934766
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gerontology Nurse Practitioner
- License
- 257544
- Practice address
- 13851 County Road 194
Tyler, TX 75703-6621 - Phone
- (210) 415-3189
- NPI assigned
- Dec 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gerontology Nurse Practitioner | 363LG0600X | 257544 | TX | Primary |
Addresses
Primary practice location
13851 County Road 194
Tyler, TX 75703-6621
Mailing address
13851 County Road 194
Tyler, TX 75703-6621
Phone (210) 415-3189
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 257544 | Other | TX | LICENSE NUMBER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Registered Nurse
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Heather L Bowles | Past | Accepting new patients |
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.
-
- General Practice Physician
- Larue, TX
- NPI 1114151974
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262131200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1262131200000",
"number": "1982934766",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13851 COUNTY ROAD 194",
"city": "TYLER",
"state": "TX",
"postal_code": "757036621",
"telephone_number": "210-415-3189"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13851 COUNTY ROAD 194",
"city": "TYLER",
"state": "TX",
"postal_code": "757036621",
"telephone_number": "210-415-3189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOSBY",
"first_name": "SANDRA",
"middle_name": "A",
"credential": "RN, GNP-BS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-12-30",
"last_updated": "2009-12-30",
"status": "A"
},
"taxonomies": [
{
"code": "363LG0600X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Gerontology",
"state": "TX",
"license": "257544",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE NUMBER",
"identifier": "257544",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.