Kimberly Moore

Primary specialty

Sports Medicine (Preventive Medicine) PhysicianTaxonomy code 2083S0010X

License

AT8208 Issued in TX

Practice address

1333 W Washington St
Stephenville, TX 76401-4168

Phone

(254) 968-9175

NPI assigned

Jul 24, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1595548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595548800000",
    "number": "1013526201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 W LINGLEVILLE RD APT 107",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011825",
            "telephone_number": "910-650-4237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1333 W WASHINGTON ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764014168",
            "telephone_number": "254-968-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-24",
        "last_updated": "2020-07-24",
        "certification_date": "2020-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083S0010X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Sports Medicine",
            "state": "TX",
            "license": "AT8208",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD",
            "identifier": "ZGP529006652",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sw_kmoore2@tarleton.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "Tarleton State University",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Tarleton State University",
            "address_1": "1650 W Lingleville Rd Apt 107",
            "city": "Stephenville",
            "state": "TX",
            "country_code": "US",
            "postal_code": "764011825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Monty Banks OD PA
• Samuel Moon, OD
• Abrahia Moore
• David A Moore, O.D.
• Jeffrey Moore, M.D.
• Morgan Mill Isd
• Kimberly Mory, SLP
• Katherine Jones Muir, MA,CCC-A
• Mulberry Manor LLC
• Nance Chiropractic Clinic, P.C.

• Sports Medicine (Preventive Medicine) Physician in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Sports Medicine (Preventive Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.