Individual provider Active NPI

Christina Adele Moore, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Kennewick, WA
National Provider Identifier
1053850040
Registry record updated May 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP61104074 Issued in WA
Practice address
7360 W Deschutes Ave
Kennewick, WA 99336-7774
Phone
(509) 783-0144
Fax
(509) 783-8244
NPI assigned
Feb 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X N261111233 WA
Adult Health Nurse Practitioner 363LA2200X AP61104074 WA
Family Nurse Practitioner 363LF0000X 77577 KS
Family Nurse Practitioner 363LF0000X AP61104074 WA Primary

Addresses

Primary practice location

7360 W Deschutes Ave
Kennewick, WA 99336-7774

Mailing address

550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 942-3627

Other practice location 1

2650 Shawnee Mission Pkwy
Westwood, KS 66205-2003
Phone (913) 588-7750

Other names 1

  • Christina Adele Harris Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201123002669 WA Practitioner - Nurse Practitioner 0648557850 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kadlec Regional Medical CenterGroup PAC ID 9739098617, 402 clinicians

Practice addresses (Care Compare)

7360 W Deschutes Ave
Kennewick, WA 99336-7774
Phone (509) 783-0144

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
N261111233WAMDAdult Health Nurse Practitioner
77577KSMDFamily Nurse Practitioner
AP61104074WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kadlec Regional Medical Center CurrentSince Dec 7, 2020 Accepting new patients
Kadlec Regional Medical Center CurrentSince Dec 7, 2020 Accepting new patients
Kadlec Regional Medical Center Current Accepting new patients

Locations

7360 W Deschutes Ave
Kennewick, WA 99336
Phone (509) 783-0144

888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115

550 Gage Blvd
Ste 101
Richland, WA 99352

1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300

Organizations & group practices 3

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1487808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621468800000",
    "number": "1053850040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 GAGE BLVD STE 101",
            "city": "RICHLAND",
            "state": "WA",
            "postal_code": "993529532",
            "telephone_number": "509-942-3627",
            "fax_number": "509-627-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7360 W DESCHUTES AVE",
            "city": "KENNEWICK",
            "state": "WA",
            "postal_code": "993367774",
            "telephone_number": "509-783-0144",
            "fax_number": "509-783-8244"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2650 Shawnee Mission Pkwy",
            "address_purpose": "LOCATION",
            "city": "Westwood",
            "state": "KS",
            "postal_code": "662052003",
            "country_code": "US",
            "telephone_number": "913-588-7750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTINA",
        "middle_name": "ADELE",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-02-23",
        "last_updated": "2021-05-20",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "N261111233",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "WA",
            "license": "AP61104074",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KS",
            "license": "77577",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61104074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "HARRIS",
            "middle_name": "ADELE",
            "credential": "MSN, APRN, FNP-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennewick, WA

Sources for this page

Verify at the official NPI Registry.