Martin Louis Moore, APN RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

APN000704 Issued in NV

Practice address

3961 S McCarran Blvd
Reno, NV 89502-7510

Phone

(775) 683-3444

Fax

(775) 683-3222

NPI assigned

Oct 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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

{
    "created_epoch": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527033600000",
    "number": "1073501797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3961 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895027510",
            "telephone_number": "775-683-3444",
            "fax_number": "775-683-3222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 S MCCARRAN BLVD",
            "city": "RENO",
            "state": "NV",
            "postal_code": "895027510",
            "telephone_number": "775-683-3444",
            "fax_number": "775-683-3222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4834 Sparks Blvd",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "NV",
            "postal_code": "894368215",
            "country_code": "US",
            "telephone_number": "775-356-8100",
            "fax_number": "775-356-8101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARTIN",
        "middle_name": "LOUIS",
        "name_prefix": "Mr.",
        "credential": "APN RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-06",
        "last_updated": "2018-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NV",
            "license": "APN000704",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "500026966",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kellyn Desiree Moore, B.S.
• Kenshawn Moore
• Kimberly Moore
• Kristin Moore
• Lendsey Moore
• Michael Kevin Moore, M.D., M.S.
• Michelle Ann Moore, RNFA
• Mitchell Moore
• Shay Moore, RN
• Susan Joana Moore, N.P.

• Nurse Practitioner in Reno, NV
• Providers in Reno, NV by specialty
• Nurse Practitioner in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2018; 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.