Individual provider Active NPI

D'Nia Maria Moore, LPN

  • Licensed Practical Nurse
  • Canton, OH
National Provider Identifier
1124850565
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
LPN.189981 Issued in OH
Practice address
2600 Sixth St SW
Canton, OH 44710-1702
Phone
(330) 830-3393
Fax
(234) 521-7091
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X LPN.189981 OH Primary

Addresses

Primary practice location

2600 Sixth St SW
Canton, OH 44710-1702

Mailing address

625 Cleveland Ave NW
Canton, OH 44702-1805
Phone (330) 455-0374

Other practice location 1

1680 Nave Rd SE
Massillon, OH 44646-9604
Phone (330) 830-8740

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

State licenses

LicenseStateTypeSpecialty
LPN.189981OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1124850565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLEVELAND AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447021805",
            "telephone_number": "330-455-0374",
            "fax_number": "330-453-6716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 SIXTH ST SW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447101702",
            "telephone_number": "330-830-3393",
            "fax_number": "234-521-7091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1680 Nave Rd SE",
            "address_purpose": "LOCATION",
            "city": "Massillon",
            "state": "OH",
            "postal_code": "446469604",
            "country_code": "US",
            "telephone_number": "330-830-8740",
            "fax_number": "330-830-1912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "D'NIA",
        "middle_name": "MARIA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.189981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.