Kevin Thomas Moore, DNP, MSN, RN

Primary specialty

Administrator Registered NurseTaxonomy code 163WA2000X

License

685106-01 Issued in NY

Practice address

1 Park Ave Ofc 3-361
New York, NY 10016-5802

Phone

(347) 802-6895

NPI assigned

Jan 9, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1704758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704758400000",
    "number": "1104697127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PARK AVE OFC 3-361",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165802",
            "telephone_number": "347-802-6895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PARK AVE OFC 3-361",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100165802",
            "telephone_number": "347-802-6895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DNP, MSN, RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-09",
        "last_updated": "2024-01-09",
        "certification_date": "2024-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NY",
            "license": "685106-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joy A Moore, LPN
• Judith E Moore, LCSW
• Kalisa Moore
• Kathryn Moore, PMHNP
• Kerry Moore, PHD, LP
• Kiara Moore
• Kim Moore
• Kimberly Moore, LCSW
• Kristin Moore, LCSW
• Laura Moore, MD PHD

• Administrator Registered Nurse in New York, NY
• Providers in New York, NY by specialty
• Administrator Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2024; 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.