SHANNON K CARMONA MOSES (NPI# 1932485489) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932485489 |
| Entity Type | Individual |
| Full Name | SHANNON K CARMONA MOSES |
| Credential | N.P. |
| Practice Address |
4855 S Moorland Rd Fl 3 New Berlin WI 53151-7494 |
| Mailing Address |
9000 W Wisconsin Ave # Ms 958 Milwaukee WI 53226-4874 |
| Practice Telephone | 2624327599 |
| Practice Fax Number | 2624327694 |
| Mailing Telephone | 4142667615 |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2020-06-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 4680-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
4680-33 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 1932485489 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1284 N Summit Ave, Oconomowoc, WI 530664459 | 2625693080 | |
| 611 W National Ave, Milwaukee, WI 532041714 | 4143841400 | 4146727012 |
| Street Address |
4855 S MOORLAND RD FL 3 |
| City | NEW BERLIN |
| State | WI |
| Zip Code | 53151-7494 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851369748 | Kristin M Millin | Pediatrics | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2006-03-08 |
| 1013525096 | Katherine Ciminelli Waller | Nurse Practitioner | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2020-07-16 |
| 1922585223 | Jessica Pflieger | Registered Nurse | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2018-07-19 |
| 1881057065 | Anna B Pokrzywinski | Nurse Practitioner | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2016-04-04 |
| 1700144698 | Rebecca Gayle Martinie | Pediatrics | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2012-04-27 |
| 1538325071 | Julia Fischer Romeiser | Pediatrics | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2008-08-04 |
| 1932216975 | Kristine M Wake | Pediatrics | 4855 S Moorland Rd Fl 3, New Berlin, WI 53151-7494 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629527486 | Natural Look Salon and Wigs LLC | Durable Medical Equipment & Medical Supplies | 4805 S. Moorland Rd, New Berlin, WI 53151 | 2016-09-22 |
| 1396193033 | New Berlin Medical Services, LLC | Clinic/Center | 15324 W Beloit Road, New Berlin, WI 53151 | 2016-06-02 |
| 1063899680 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 15300 West Grange Avenue, New Berlin, WI 53151 | 2015-05-04 |
| 1871970368 | Mary Spath | Physical Therapy Assistant | 2810 South Acredale Road, New Berlin, WI 53151 | 2015-05-04 |
| 1669885471 | Wauwatosa Prescription Center, Inc. | Pharmacy | 4855 S Moorland Road, New Berlin, WI 53151 | 2014-06-09 |
| 1750711446 | Pure Family Chiropractic LLC | Chiropractor | 3504 S. Moorland Road, New Berlin, WI 53151 | 2013-11-18 |
| 1336578202 | Hamilton John Dowden | Chiropractor | 3504 S Moorland Rd, New Berlin, WI 53151 | 2013-11-01 |
| 1053653618 | Danielle Lynn Lucio | Acupuncturist | 15807 W. National Ave., New Berlin, WI 53151 | 2013-03-21 |
| 1306195110 | Marlena J Friedrich | Registered Nurse | 1709 S. 171st Street, New Berlin, WI 53151 | 2012-09-07 |
| 1548519176 | Patricia M Friedrich | Licensed Practical Nurse | 1709 So. 171st Street, New Berlin, WI 53151 | 2012-08-29 |
| Find all providers in zip 53151 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760967525 | Jenelle Kubiak | Nurse Practitioner | 2775 S Moorland Rd Ste 201, New Berlin, WI 53151-3718 | 2018-09-27 |
| 1366603581 | Kim Marie Wolf | Nurse Practitioner | 13800 W Maria Dr, New Berlin, WI 53151-6889 | 2008-06-20 |
| 1427095405 | Thomas Freichels, Cs, Apnp | Nurse Practitioner | 14854 W Mayflower Ct, New Berlin, WI 53151-6747 | 2006-05-31 |
| 1669951737 | Rachel Kriz | Nurse Practitioner | 4805 S Moorland Rd, New Berlin, WI 53151-7401 | 2018-08-09 |
| 1962832576 | Megan L Bucaro | Nurse Practitioner | 4855 S Moorland Rd, Suite 150, New Berlin, WI 53151-7494 | 2013-11-18 |
| 1871825323 | Jenny L. Martin | Nurse Practitioner | 14555 W National Ave, New Berlin, WI 53151 | 2010-02-09 |
| 1295842649 | Jennifer J Nicpon | Nurse Practitioner | 12901 W National Ave, New Berlin, WI 53151-4063 | 2006-08-23 |
| 1013022037 | Dennis J Garvin | Nurse Practitioner | 12901 W National Ave, New Berlin, WI 53151-4063 | 2006-08-20 |
| 1457394991 | Thomas Allan Freichels | Nurse Practitioner | 14854 W Mayflower Ct, New Berlin, WI 53151-6747 | 2006-06-13 |
| 1093768871 | Amanda M Kotowski | Nurse Practitioner | 4855 S Moorland Rd, 3rd Floor, New Berlin, WI 53151-7494 | 2006-05-19 |
| Find all providers in NEW BERLIN | ||||
| City | NEW BERLIN |
| Zip Code | 53151 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.