Active NPI
Deven Moore
- Registered Nurse
- Geneva, NY
National Provider Identifier
1053869453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 630125
- Practice address
- 601B W Washington St
Geneva, NY 14456-2119 - Phone
- (315) 781-8448
- Fax
- (315) 781-8444
- NPI assigned
- Sep 14, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 630125 | NY | Primary |
Addresses
Primary practice location
601B W Washington St
Geneva, NY 14456-2119
Mailing address
14 Maiden LN
Penn Yan, NY 14527-1208
Phone (315) 531-9102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 630125 | Other | NY | LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 630125 | NY | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473811200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1053869453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 MAIDEN LN",
"city": "PENN YAN",
"state": "NY",
"postal_code": "145271208",
"telephone_number": "315-531-9102",
"fax_number": "315-531-9103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601B W WASHINGTON ST",
"city": "GENEVA",
"state": "NY",
"postal_code": "144562119",
"telephone_number": "315-781-8448",
"fax_number": "315-781-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DEVEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-14",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "NY",
"license": "630125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "630125",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Geneva, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.