Isaac Moore, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4516 Issued in AL

Practice address

4110 Fitzpatrick Blvd Apt 2401
Montgomery, AL 36116-4835

Phone

(251) 508-6900

NPI assigned

Oct 12, 2022

Sex

Male

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

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gardenia Cove Mental Health PCGroup PAC ID 0648534537, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Gardenia Cove Mental Health PC

  • Psychiatry Physician
  • Montgomery, AL
  • NPI 1063912301
  Medicare reassignment Care Compare group NPD
• Rivertown Psychiatry, PC

  • Psychiatry Physician
  • Columbus, GA
  • NPI 1023362852

  AL

  Medicare reassignment NPD

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1174249163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 FITZPATRICK BLVD APT 2401",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361164835",
            "telephone_number": "251-508-6900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 FITZPATRICK BLVD APT 2401",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361164835",
            "telephone_number": "251-508-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ISAAC",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AL",
            "license": "4516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moore Healing LLC
• Cassandra Moore, LPC
• Chavona Prinshay Moore, CRNP
• Daniel L Moore, MD
• Edward Ryan Moore, RN, CRNP
• Jennifer Massey Moore, FNP-C
• Kristin Moore, MSW, LCSW
• Mariel Dees Moore
• Melissa S Moore
• Michael Shane Moore, LPTA

• Professional Counselor in Montgomery, AL
• Providers in Montgomery, AL by specialty
• Professional Counselor in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.