Emily Rebecca Moore, MS, RD, CD, CSO

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

253129 Issued in WI

Practice address

1515 Park Ave
Columbus, WI 53925-1618

Phone

(920) 350-2672

Fax

(920) 623-1250

NPI assigned

Dec 17, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Emily Briggs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1355702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701302400000",
    "number": "1124364377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-350-2672",
            "fax_number": "920-623-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 PARK AVE",
            "city": "COLUMBUS",
            "state": "WI",
            "postal_code": "539251618",
            "telephone_number": "920-350-2672",
            "fax_number": "920-623-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EMILY",
        "middle_name": "REBECCA",
        "credential": "MS, RD, CD, CSO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-12-17",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "WI",
            "license": "253129",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "BRIGGS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Mikulas, PT, DPT
• Colin Tolentino Millar, MD
• Kendra Minick
• Thomas Mitchell, MD
• Valerie Monthie, RN ,WCC
• Matthew C Niesen, M.D.
• Andrew Nothem, D.D.S.
• Kelly C O'Heron, RD CD
• Dennis A Oeth, MD
• Debbie Oldenburg, D.C.

• Registered Dietitian in Columbus, WI
• Providers in Columbus, WI by specialty
• Registered Dietitian in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.