Nichole Lynn Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

126503.MEDS-IV Issued in OH

Practice address

100 Elmwood Park Dr
Dayton, OH 45449-5402

Phone

(937) 247-9015

NPI assigned

Apr 16, 2019

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)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/recoveryworkshealingcenter/r4/

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.

• Recovery Works Holding Company LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Dayton, OH
  • NPI 1376910505
  NPD (past)

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1023671963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W WASHINGTON ST",
            "city": "NEW CARLISLE",
            "state": "OH",
            "postal_code": "453441552",
            "telephone_number": "937-765-2229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ELMWOOD PARK DR",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454495402",
            "telephone_number": "937-247-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NICHOLE",
        "middle_name": "LYNN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "126503.MEDS-IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Danielle Moore, R.D.
• Lauri May Moore, PTA
• Leeann Moore
• Meghan Moore, CNS
• Misty Lynne Moore, FNPC
• Octavia Moore
• Rachel Ariel Moore
• Rachel Lynn Moore
• Ryan Moore, CDCA
• Serina Moore

• Licensed Practical Nurse in Dayton, OH
• Providers in Dayton, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.