Madgell Moore, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

120203 Issued in AK

Practice address

2600 Denali St Ste 606
Anchorage, AK 99503-2754

Phone

(907) 343-9207

NPI assigned

Jun 28, 2017

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Peninsula Community Health Services of Alaska, Inc.

  • Federally Qualified Health Center (FQHC)
  • Soldotna, AK
  • NPI 1700984614

  Clinical

  NPD (past)

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

{
    "created_epoch": "1498608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498608000000",
    "number": "1073034369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ROSALIND LOOP",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995073674",
            "telephone_number": "907-360-0403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 DENALI ST STE 606",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995032754",
            "telephone_number": "907-343-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MADGELL",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-28",
        "last_updated": "2017-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AK",
            "license": "120203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry Moore
• Jonathan Kurtis Moore, CRNA
• Julia R Moore, M.AC, LICAC,DIPL. AC
• Kathryn McCallum Moore
• Laura M Moore, MD
• Merijeanne Anne Moore, DO
• Nichell Moore, PHARM.D.
• Phillip Moore
• Rochellene Moore, LMT
• Ryan Timothy Moore, M.D.

• Clinical Social Worker in Anchorage, AK
• Providers in Anchorage, AK by specialty
• Clinical Social Worker in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2017; 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.