Active NPI
Linnea Mary Moore, BA
- Other Technician
- Mankato, MN
National Provider Identifier
1124581947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Other Technician
- Practice address
- 1720 Bassett Dr
Mankato, MN 56001-6569 - Phone
- (507) 565-0150
- NPI assigned
- Apr 9, 2019
- Last updated
- Dec 14, 2020
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | |||
| Other Technician | 247200000X | Primary |
Addresses
Primary practice location
1720 Bassett Dr
Mankato, MN 56001-6569
Mailing address
1720 Bassett Dr
Mankato, MN 56001-6569
Phone (507) 565-0150
Other practice location 1
7010 Highway 7
St Louis Park, MN 55426-4223
Phone (952) 814-0207
Other practice location 2
1725 Kenwood Ave Apt 110
Duluth, MN 55811-2267
Phone (507) 317-7499
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
- Bachelor of Arts
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Behavioral Dimensions, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Cognitive & Behavioral Psychologist
- St Louis Park, MN
- NPI 1831236785
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607904000000",
"number": "1124581947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1720 BASSETT DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016569",
"telephone_number": "507-565-0150"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 BASSETT DR",
"city": "MANKATO",
"state": "MN",
"postal_code": "560016569",
"telephone_number": "507-565-0150"
}
],
"practiceLocations": [
{
"address_1": "7010 Highway 7",
"address_purpose": "LOCATION",
"city": "St Louis Park",
"state": "MN",
"postal_code": "554264223",
"country_code": "US",
"telephone_number": "952-814-0207",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1725 Kenwood Ave Apt 110",
"address_purpose": "LOCATION",
"city": "Duluth",
"state": "MN",
"postal_code": "558112267",
"country_code": "US",
"telephone_number": "507-317-7499",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "LINNEA",
"middle_name": "MARY",
"name_prefix": "Miss",
"credential": "BA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-09",
"last_updated": "2020-12-14",
"certification_date": "2020-12-14",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": false
},
{
"code": "247200000X",
"taxonomy_group": "",
"desc": "Technician, Other",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.