Active NPI
Renell Moore, SLP
- Speech-Language Pathologist
- Burleson, TX
National Provider Identifier
1003561226
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 111824
- Practice address
- 12000 Oak Grove Rd S
Burleson, TX 76028-6685 - Phone
- (817) 245-3800
- NPI assigned
- Feb 16, 2022
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 111824 | TX | Primary |
Addresses
Primary practice location
12000 Oak Grove Rd S
Burleson, TX 76028-6685
Mailing address
1160 SW Wilshire Blvd
Burleson, TX 76028-5719
Phone (817) 245-1000
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | renell.moore@bisdmail.net | Direct | |
| Other URL | renell.moore@bisdmail.net | Direct |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 111824 | TX | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644969600000",
"number": "1003561226",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1160 SW WILSHIRE BLVD",
"city": "BURLESON",
"state": "TX",
"postal_code": "760285719",
"telephone_number": "817-245-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12000 OAK GROVE RD S",
"city": "BURLESON",
"state": "TX",
"postal_code": "760286685",
"telephone_number": "817-245-3800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "RENELL",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-16",
"last_updated": "2022-02-16",
"certification_date": "2022-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "111824",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "renell.moore@bisdmail.net",
"affiliation": "N",
"endpointDescription": "business email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "12000 Oak Grove Rd S",
"city": "Burleson",
"state": "TX",
"country_code": "US",
"postal_code": "760286685",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "renell.moore@bisdmail.net",
"affiliation": "N",
"endpointDescription": "business email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "12000 Oak Grove Rd S",
"city": "Burleson",
"state": "TX",
"country_code": "US",
"postal_code": "760286685",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Burleson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.