Rebecca Ruth Moore

Primary specialty

Neonatal Nurse PractitionerTaxonomy code 363LN0000X

License

4704301129 Issued in MI

Practice address

2799 W Grand Blvd
Detroit, MI 48202-2608

Phone

(800) 653-6568

Fax

(313) 876-1305

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: rwright283001@direct.hfhs.org

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1043610033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 FORD PL STE 3A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023450",
            "telephone_number": "313-874-4806",
            "fax_number": "313-876-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2799 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022608",
            "telephone_number": "800-653-6568",
            "fax_number": "313-876-1305"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2873 Scenic Ct",
            "address_2": "Apt. 104",
            "address_purpose": "LOCATION",
            "city": "Lake Orion",
            "state": "MI",
            "postal_code": "483602370",
            "country_code": "US",
            "telephone_number": "810-358-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REBECCA",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4703110355",
            "primary": false
        },
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MI",
            "license": "4704301129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Anne Moore, MA L.L.P.
• Moriah Jean Moore, DO
• Mykah Amarie Moore
• Nolan Keith Moore, LPC
• Rachelle Elizabeth Moore, MD
• Rosalyn Russell Moore, RN BSN
• Samella Moore
• Sarah Anna Moore, LMSW
• Shannon Moore, DNP, FNP-BC
• Sharee Lynette Moore, LPN

• Neonatal Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Neonatal Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.