Michelle Wagner Moore, PHD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

PO Box 6122
Morgantown, WV 26506-6122

Phone

(304) 293-6817

NPI assigned

Jul 28, 2017

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

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.

• West Virginia University

  • Speech-Language Pathologist
  • Morgantown, WV
  • NPI 1477742708
  NPD (past)

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

{
    "created_epoch": "1501200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501200000000",
    "number": "1023532223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6122",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265066122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PO BOX 6122",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265066122",
            "telephone_number": "304-293-6817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHELLE",
        "middle_name": "WAGNER",
        "name_prefix": "Dr.",
        "credential": "PHD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-28",
        "last_updated": "2017-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kamille Destiny Moore
• Kristen Nicole Moore, M.D.
• Lisa Marie Moore, RN
• Lyndsi Moore, OTR/L
• Michelle Lynn Moore, CRC
• Misty Ann Moore, M.ED., BCBA
• Sarah Marie Moore, FNP-C
• Ta'Tyana Ariel Moore
• Tanner Moore, DO
• Benjamin D Moorehead, M.D.

• Speech-Language Pathologist in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Speech-Language Pathologist in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2017; 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.