David A Moore

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

1460 Michaels Rd
Tipp City, OH 45371-2030

Phone

(937) 430-5647

NPI assigned

Nov 13, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1605225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605225600000",
    "number": "1093317018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1460 MICHAELS RD",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453712030",
            "telephone_number": "937-430-5647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MICHAELS RD",
            "city": "TIPP CITY",
            "state": "OH",
            "postal_code": "453712030",
            "telephone_number": "937-430-5647"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DAVID",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-11-13",
        "last_updated": "2020-11-13",
        "certification_date": "2020-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5504761",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "davidmoore2010@yahoo.com",
            "affiliation": "N",
            "address_1": "1460 Michaels Rd",
            "city": "Tipp City",
            "state": "OH",
            "country_code": "US",
            "postal_code": "453712030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ellen M Miller, LPCC
• Jessica Sommer Miller
• Samantha Miller
• Miray Home Health Care Inc
• Lisa Mitchell
• Municipality of Tipp City
• Amy Lynn Myers, OD
• Heather N Myers, PHARMD
• Jennifer D Myers, LMT
• Nash Integrative Medicine, Inc.

• Social Worker in Tipp City, OH
• Providers in Tipp City, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2020; 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.