Active NPI
Fausto H Mora, PHD
- Psychologist
- Kansas City, MO
National Provider Identifier
1144235631
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 00323
- Practice address
- 825 Euclid Avenue
Kansas City, MO 64124-2323 - Phone
- (816) 474-4920
- Fax
- (816) 474-4914
- NPI assigned
- Jul 31, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 00323 | MO | Primary |
Addresses
Primary practice location
825 Euclid Avenue
Kansas City, MO 64124-2323
Mailing address
10408 Garnett St
Overland Park, KS 66214-2655
Phone (816) 474-4920
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00323 | Other | MO | PH.D. |
| C16A346 | Other | MO | MEDICARE B WHEATLANDS |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00323 | MO | MD | Psychologist |
| 6027 | OH | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154304000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1144235631",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10408 GARNETT ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662142655",
"telephone_number": "816-474-4920",
"fax_number": "816-474-4914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "825 EUCLID AVENUE",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641242323",
"telephone_number": "816-474-4920",
"fax_number": "816-474-4914"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORA",
"first_name": "FAUSTO",
"middle_name": "H",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-31",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MO",
"license": "00323",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PH.D.",
"identifier": "00323",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE B WHEATLANDS",
"identifier": "C16A346",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.