Individual provider Active NPI

Ileana Moore

  • Case Manager/Care Coordinator
  • Newport, OR
National Provider Identifier
1194489625
Registry record updated Oct 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
407 N Coast Hwy Ste 300
Newport, OR 97365-3117
Phone
(503) 390-5637
Fax
(541) 264-7515
NPI assigned
Oct 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

407 N Coast Hwy Ste 300
Newport, OR 97365-3117

Mailing address

407 N Coast Hwy Ste 300
Newport, OR 97365-3117
Phone (503) 390-5637

Other names 1

  • Ileana Flores Former name

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

NPI Registry JSON

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

{
    "created_epoch": "1635552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635552000000",
    "number": "1194489625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 N COAST HWY STE 300",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653117",
            "telephone_number": "503-390-5637",
            "fax_number": "541-264-7515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 N COAST HWY STE 300",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973653117",
            "telephone_number": "503-390-5637",
            "fax_number": "541-264-7515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ILEANA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-30",
        "last_updated": "2021-10-30",
        "certification_date": "2021-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ILEANA",
            "last_name": "FLORES",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Newport, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2021; 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.