Marisa Moore, APRN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN278019 Issued in GA

Practice address

915 6TH Ave Ste 100
Tacoma, WA 98405-4682

Phone

(253) 403-7277

NPI assigned

Apr 13, 2020

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

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  Multi-Specialty

  Medicare reassignment NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD
• Multicare Health System

  • Pediatrics Physician
  • Puyallup, WA
  • NPI 1700396652

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1586736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1194344788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "325 POSTWOOD DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302157604",
            "telephone_number": "678-873-0958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 6TH AVE STE 100",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054682",
            "telephone_number": "253-403-7277"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Clifton Rd NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303221060",
            "country_code": "US",
            "telephone_number": "678-873-0958",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "325 Postwood Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "GA",
            "postal_code": "302157604",
            "country_code": "US",
            "telephone_number": "678-873-0958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARISA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-04-13",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse",
            "state": "GA",
            "license": "RN278019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kari Lynn Moore
• Kathryn Anne Moore, LMP
• Kayla Moore, MS, LMFT
• Kimberly Lynn Moore, MD
• Maloy Moore
• Montaisha Dechelle Moore
• Peanina Savea Ah San Moore
• Stephani Moore, ED.M., LBA, BCBA
• Tamie Moore, AAC
• Tasheea R Moore, HOME CARE AID LICENS

• Registered Nurse in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Registered Nurse in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.