Shefanie Raychel Moore

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

Practice address

2300 Greenwood Rd
Attn: Recovery Audit
Shreveport, LA 71103

Phone

(318) 212-2695

Fax

(318) 212-2689

NPI assigned

Jul 16, 2021

Last updated

Aug 12, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

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.

• Willis Knighton Health System

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1336721786
  NPD Authorized official

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

{
    "created_epoch": "1626393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1144892381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 GREENWOOD RD",
            "address_2": "ATTN: RECOVERY AUDIT",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-212-2695",
            "fax_number": "318-212-2689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 GREENWOOD RD",
            "address_2": "ATTN: RECOVERY AUDIT",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "71103",
            "telephone_number": "318-212-2695",
            "fax_number": "318-212-2689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHEFANIE",
        "middle_name": "RAYCHEL",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-16",
        "last_updated": "2022-08-12",
        "certification_date": "2021-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://protect-us.mimecast.com/s/F1aSC4xqEkiBlWkvHxFA1y?domain=esmdprod.craneware.com",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.17.9.1",
            "affiliationName": "Willis Knighton Medical Center, Inc.",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3340 Peachtree. N.E.",
            "address_2": "Suite 850",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "30326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Norman Thomas Moore, LPC, LMFT
• Peyton Moore
• Rachel Harrison Moore
• Shakisha Moore, LMSW
• Sharon E. Moore, RN
• Taffi Moore, PHYSICAL THERAPIST
• Tamara Lynn Moore, M.D.
• Tamara Renese Moore
• Terry Eileen Moore, LPC
• Valentina Moore

• Preferred Provider Organization in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Preferred Provider Organization in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2022; 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.