Individual provider Active NPI

Robert Montgomery Moore, MHR, LPC

  • Mental Health Counselor
  • Norman, OK
National Provider Identifier
1083746903
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3372 Issued in OK
Practice address
2201 Westpark Dr
Norman, OK 73069-4012
Phone
(405) 579-4111
Fax
(405) 579-4223
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 3372 OK
Mental Health Counselor 101YM0800X 3372 OK Primary

Addresses

Primary practice location

2201 Westpark Dr
Norman, OK 73069-4012

Mailing address

120 McSha PL
Norman, OK 73072-3863
Phone (405) 650-6028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240103004757 OK Practitioner - Mental Health Counselor 2567813595 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Norman Psychiatry Aprn-CNP PLLCGroup PAC ID 3971866484, 10 clinicians

Practice addresses (Care Compare)

2201 Westpark Dr
Norman, OK 73069-4012
Phone (405) 579-4111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Norman Psychiatry Aprn-CNP PLLC CurrentSince Jan 1, 2024 Accepting new patients

Locations

2201 Westpark Dr
Norman, OK 73069
Phone (405) 579-4111

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1083746903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 MCSHA PL",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730723863",
            "telephone_number": "405-650-6028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 WESTPARK DR",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730694012",
            "telephone_number": "405-579-4111",
            "fax_number": "405-579-4223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROBERT",
        "middle_name": "MONTGOMERY",
        "credential": "MHR, LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "3372",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "3372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norman, OK

Sources for this page

Verify at the official NPI Registry.