NICOLLE RENEE AHLES-MOSES, APRN, CNP — NPI 1902006166 (Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) in COON RAPIDS, MN)

CMS-1500 Box 24J / 33a • NPI

1902006166

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

363LP0200X (CMS 50)

Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)

Box 32 Service Location & ZIP+4

10081 DOGWOOD ST NW STE 100, COON RAPIDS, MN, 55448-5282

✓ 9-Digit EDI 837 ZIP+4 (55448-5282)

Practice Phone & Referral Fax

(763) 783-3722

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1902006166 (NICOLLE RENEE AHLES-MOSES, APRN, CNP) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1902006166` (NPI-1 Individual Practitioner)
Provider / Legal Name	NICOLLE RENEE AHLES-MOSES, APRN, CNP
Plain-English Specialty	Board-Certified Pediatrician (Infant, Child & Adolescent Medicine) NUCC Code: `363LP0200X` (Nurse Practitioner, Pediatrics)
Certifying / Licensing Body	American Board of Pediatrics (ABP)
Practice Location Address	10081 DOGWOOD ST NW STE 100, COON RAPIDS, MN, 55448-5282
Practice Telephone / Fax	Tel: (763) 783-3722
Administrative Mailing Address	10081 DOGWOOD ST NW STE 100, COON RAPIDS, MN, 55448-5282
Enumeration & Last Sync	Enumerated: 2007-07-24 \| CMS Record Updated: 2018-03-17

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

10081 DOGWOOD ST NW STE 100, COON RAPIDS, MN, 55448-5282

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Plain-English Taxonomy & CMS Crosswalk (363LP0200X)

What Does Taxonomy Code 363LP0200X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0200X translates to:
"Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 50 (Nurse Practitioner)
Certifying / Accrediting Authority: American Board of Pediatrics (ABP)
Clinical Scope: Newborn jaundice screening, routine childhood vaccinations, developmental milestones, pediatric fevers, ear infections, asthma, or acute gastroenteritis.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (NICOLLE RENEE AHLES-MOSES, APRN, CNP)

Typical CPT / Diagnostic Procedures:

Comprehensive Well-Child Developmental & Growth Visits (CPT 99381–99394)
Childhood Immunization Administration (Rotavirus, MMR, DTaP, HPV, PCV)
Neonatal Bilirubin & Jaundice Transcutaneous/Serum Screening
Rapid Streptococcal, RSV & Influenza Point-of-Care Diagnostics
Pediatric Asthma Nebulization & Spirometry Evaluation

Common Therapeutic Classes:

Amoxicillin / Amoxicillin-Clavulanate (Pediatric Otitis Media & Sinusitis)
WHO Low-Osmolarity Oral Rehydration Salts (ORS) & Zinc Sulfate
Albuterol Sulfate Inhalers & Fluticasone Pediatric Inhalers
Weight-Based Acetaminophen & Ibuprofen Antipyretic Suspensions

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`363LP0200X` — Nurse Practitioner, Pediatrics Plain English: Board-Certified Pediatrician (Infant, Child & Adolescent Medicine)	State: MN \| License: `CNP1814` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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NICOLLE RENEE AHLES-MOSES, APRN, CNP (NPI #1902006166)