Kerry E Moore, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN1063076 Issued in DC

Practice address

6 Dupont Cir NW # 1347
Washington, DC 20036-1108

Phone

(202) 785-1466

NPI assigned

Nov 23, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

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.

• State University of New York College at Brockport

  • Student Health Clinic/Center
  • Brockport, NY
  • NPI 1033465539
  NPD (past)

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650240000000",
    "number": "1194027243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW CAMPUS DR",
            "address_2": "SUNY COLLEGE AT BROCKPORT HAZEN HEALTH CENTER",
            "city": "BROCKPORT",
            "state": "NY",
            "postal_code": "144202997",
            "telephone_number": "585-395-2414",
            "fax_number": "585-395-2559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 DUPONT CIR NW # 1347",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200361108",
            "telephone_number": "202-785-1466"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "350 New Campus Dr",
            "address_2": "SUNY College at Brockport Hazen Health Center",
            "address_purpose": "LOCATION",
            "city": "Brockport",
            "state": "NY",
            "postal_code": "144202997",
            "country_code": "US",
            "telephone_number": "585-395-2414",
            "fax_number": "585-395-2559",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KERRY",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-23",
        "last_updated": "2022-04-18",
        "certification_date": "2022-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "DC",
            "license": "RN1063076",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "336292",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kalila Rebecca Moore
• Kathy Moore, PA-C
• Kathy Arlene Moore
• Kemira Moore, HHA
• Kendall Maria Moore
• Kevin Moore
• Kiana Moore
• Kimberlin Moore, RN
• Lashawn Moore
• Latice Moore

• Family Nurse Practitioner in Washington, DC
• Providers in Washington, DC by specialty
• Family Nurse Practitioner in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.