Lavon Rena Moore, NURSE

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN-121466 Issued in OH

Practice address

7400 Merton Minter St
San Antonio, TX 78229-4404

Phone

(210) 617-5300

NPI assigned

Sep 15, 2010

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771977600000",
    "number": "1154639805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5455 ROWLEY RD UNIT 5103",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782404825",
            "telephone_number": "216-816-7754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 MERTON MINTER ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782294404",
            "telephone_number": "210-617-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAVON",
        "middle_name": "RENA",
        "name_prefix": "Mrs.",
        "credential": "NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2026-02-25",
        "certification_date": "2026-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN-121466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaylin Marie Moore
• Kelsey Anne Moore
• Kevin Matthew Moore, PA-C
• Kiara Moore
• Lauren Brittany Moore, M.D.
• Layne Rae Moore
• Magalie Moore, RN
• Maria L. Moore, COTA
• Mary A Moore, LCSW
• Mary S Moore, RN

• Licensed Practical Nurse in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Licensed Practical Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2026; 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.