Individual provider Active NPI

Lashondra M. Moore, RN, CNS

  • Gerontology Clinical Nurse Specialist
  • Tuskegee, AL
National Provider Identifier
1184878704
Registry record updated Mar 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Clinical Nurse SpecialistTaxonomy code 364SG0600X
License
12.007020 Issued in CT
Practice address
2400 Hospital Rd
Tuskegee, AL 36083-5001
Phone
(334) 272-4670
NPI assigned
Nov 10, 2008
Last updated
Mar 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gerontology Clinical Nurse Specialist 364SG0600X 12.007020 CT Primary
Registered Nurse 163W00000X 1-090450 AL

Addresses

Primary practice location

2400 Hospital Rd
Tuskegee, AL 36083-5001

Mailing address

3117 Sheldon LN
Montgomery, AL 36108-1603
Phone (334) 546-0996

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)
Not enrolled
Credentials
Certified Nurse Specialist, Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-090450ALMDRegistered Nurse
12.007020CTMDGerontology Clinical Nurse Specialist

NPI Registry JSON

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

{
    "created_epoch": "1226275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710201600000",
    "number": "1184878704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3117 SHELDON LN",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361081603",
            "telephone_number": "334-546-0996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 HOSPITAL RD",
            "city": "TUSKEGEE",
            "state": "AL",
            "postal_code": "360835001",
            "telephone_number": "334-272-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LASHONDRA",
        "middle_name": "M.",
        "credential": "RN, CNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-10",
        "last_updated": "2024-03-12",
        "certification_date": "2024-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SG0600X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Gerontology",
            "state": "CT",
            "license": "12.007020",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-090450",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuskegee, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2024; 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.