Active NPI
Brittany Leanne Moore, RD
- Registered Dietitian
- Somerset, KY
National Provider Identifier
1063734762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 2260
- Practice address
- 500 Bourne Ave
Somerset, KY 42501-1916 - Phone
- (606) 678-4761
- Fax
- (606) 676-9671
- NPI assigned
- Feb 22, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 2260 | KY | Primary |
| Nutritionist | 133N00000X | KY-2176 | KY |
Addresses
Primary practice location
500 Bourne Ave
Somerset, KY 42501-1916
Mailing address
500 Bourne Ave
Somerset, KY 42501-1916
Phone (606) 678-4761
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20001012 | Medicaid | KY | |
| 20074019 | Medicaid | KY | |
| 20100012 | Medicaid | KY | |
| 20044012 | Medicaid | KY | |
| 20101014 | Medicaid | KY | |
| 20023016 | Medicaid | KY | |
| 20029013 | Medicaid | KY | |
| 20116018 | Medicaid | KY | |
| 20901211 | Medicaid | KY | |
| 20027017 | Medicaid | KY | |
| 20109013 | Medicaid | KY |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| KY-2176 | KY | MD | Nutritionist |
| 2260 | KY | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fay Nutrition | Dietitian, Registered | Past | Accepting new patients |
| Lake Cumberland District Health Department | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Public Health Dentistry
- Somerset, KY
- NPI 1528203825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335312000000",
"number": "1063734762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "500 BOURNE AVE",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425011916",
"telephone_number": "606-678-4761",
"fax_number": "606-676-9671"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 BOURNE AVE",
"city": "SOMERSET",
"state": "KY",
"postal_code": "425011916",
"telephone_number": "606-678-4761",
"fax_number": "606-676-9671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "BRITTANY",
"middle_name": "LEANNE",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-22",
"last_updated": "2012-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "KY",
"license": "2260",
"primary": true
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "KY",
"license": "KY-2176",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20001012",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20074019",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20100012",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20044012",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20101014",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20023016",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20029013",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20116018",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20901211",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20027017",
"state": "KY"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20109013",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerset, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.