Moore Genuine Care, LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

MOORE GENUINE CARE, LLC

Practice address

711 Anderson St
Augusta, WI 54722-9002

Phone

(715) 286-2734

Fax

(715) 286-2736

NPI assigned

May 23, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charlotte Moore

Title

Member

Phone

(715) 286-2734

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1154376747. Details of each certification follow.

• CCN 527297 Home health agency · Active · Details

Home health agency certification: CCN 527297

Legal name

MOORE GENUINE CARE, LLC

Certification status

Active

Provider type (POS)

Home health agency

Participating since

Oct 16, 2006

Last certification

Feb 9, 2021

Ownership / control type

Proprietary

Organization structure

CorporationProprietary

Incorporated

May 25, 2005 in WI

Enrollment address

711 Anderson St
Augusta, WI 54722-9002

Listed as

Moore Genuine CareCCN 527297 · All quality measures

Ownership

Proprietary

Certified

Oct 16, 2006

Medicare certification status

ActiveFrom the Provider of Services file

Services

Nursing, Home health aide

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

All disclosed owners & managing parties 3

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154376747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 ANDERSON ST",
            "address_2": "LOWER LEVEL",
            "city": "AUGUSTA",
            "state": "WI",
            "postal_code": "547229002",
            "telephone_number": "715-286-2734",
            "fax_number": "715-286-2736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 ANDERSON ST",
            "city": "AUGUSTA",
            "state": "WI",
            "postal_code": "547229002",
            "telephone_number": "715-286-2734",
            "fax_number": "715-286-2736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE GENUINE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "715-286-2734"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43114200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Home Health Agency in Augusta, WI
• Providers in Augusta, WI by specialty
• Home Health Agency in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.