Jenine L Moore

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

OT24052 Issued in FL

Practice address

1143 Trotwood Blvd
Winter Springs, FL 32708-6215

Phone

(561) 568-0836

NPI assigned

Dec 9, 2022

Sex

Female

Sole proprietor

Yes

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

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Central Florida Dreamplex LLC

  • Pediatric Physical Therapist
  • Clermont, FL
  • NPI 1215017512
  Medicare reassignment NPD

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

{
    "created_epoch": "1670544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1023729175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 N CENTRAL AVE",
            "city": "KISSIMMEE",
            "state": "FL",
            "postal_code": "347414450",
            "telephone_number": "407-201-7429",
            "fax_number": "877-399-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 TROTWOOD BLVD",
            "city": "WINTER SPRINGS",
            "state": "FL",
            "postal_code": "327086215",
            "telephone_number": "561-568-0836"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JENINE",
        "middle_name": "L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-09",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT24052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MJ Childrens Pavillion, Ins
• Mojica Chiropractic Care, LLC
• Melissa Molina
• Timothy Reed Monaco
• Claudia Gabriela Montero, RBT
• Mary Kay Morrison, ARNP
• Annette Mortimer
• Patterson Webster Moseley, M.D.
• Eric Scott Moser, M.A., LMHC
• Motio Foot and Ankle Specialists PLLC

• Occupational Therapist in Winter Springs, FL
• Providers in Winter Springs, FL by specialty
• Occupational Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.