Active NPI
Casey Blythe Moore, MS, ATC, SCAT
- Student in an Organized Health Care Education/Training Program
- Greenville, SC
National Provider Identifier
1134492093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 1258
- Practice address
- 3300 Palmetto Hwy
Greenville, SC 29613-0001 - Phone
- (828) 260-1308
- NPI assigned
- Feb 22, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 1258 | SC | Primary |
Addresses
Primary practice location
3300 Palmetto Hwy
Greenville, SC 29613-0001
Mailing address
7863 Champion Way
Unit a
North Charleston, SC 29418-2210
Phone (828) 260-1308
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 |
|---|---|---|---|
| 1258 | SC | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329868800000",
"number": "1134492093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7863 CHAMPION WAY",
"address_2": "UNIT A",
"city": "NORTH CHARLESTON",
"state": "SC",
"postal_code": "294182210",
"telephone_number": "828-260-1308"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3300 PALMETTO HWY",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296130001",
"telephone_number": "828-260-1308"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CASEY",
"middle_name": "BLYTHE",
"name_prefix": "Ms.",
"credential": "MS, ATC, SCAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-02-22",
"last_updated": "2012-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "SC",
"license": "1258",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Greenville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.