Active NPI
Nima Jean Moore, MS CCCSLP
- Speech-Language Pathologist
- Austin, TX
National Provider Identifier
1114104213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 18213
- Practice address
- 2504 A Whitis
Cma 2200 A1100
Austin, TX 78712 - Phone
- (512) 471-3841
- Fax
- (512) 232-1804
- NPI assigned
- Jan 31, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 18213 | TX | Primary |
Addresses
Primary practice location
2504 A Whitis
Cma 2200 A1100
Austin, TX 78712
Mailing address
1 University Station
A1100 Cma 2200
Austin, TX 78712
Phone (512) 471-3841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18213 | TX | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas at Austin | Speech-Language Pathologist | Past | Accepting new patients |
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": "1201737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201737600000",
"number": "1114104213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 UNIVERSITY STATION",
"address_2": "A1100 CMA 2200",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78712",
"telephone_number": "512-471-3841",
"fax_number": "512-232-1804"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2504 A WHITIS",
"address_2": "CMA 2200 A1100",
"city": "AUSTIN",
"state": "TX",
"postal_code": "78712",
"telephone_number": "512-471-3841",
"fax_number": "512-232-1804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "NIMA",
"middle_name": "JEAN",
"name_prefix": "Ms.",
"credential": "MS CCCSLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-31",
"last_updated": "2008-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "TX",
"license": "18213",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.