Deidre Ann Moore, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

22002523A Issued in IN

Practice address

1060 E 86TH St
Suite 65C
Indianapolis, IN 46240-1863

Phone

(765) 621-3285

Fax

(317) 218-3462

NPI assigned

May 8, 2007

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205049152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40696",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462400696",
            "telephone_number": "765-621-3285",
            "fax_number": "317-218-3462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 E 86TH ST",
            "address_2": "SUITE 65C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462401863",
            "telephone_number": "765-621-3285",
            "fax_number": "317-218-3462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DEIDRE",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22002523A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Clayton Moore, PA
• D Scott Moore, DO
• Danisha R Moore
• David Harry Moore, MD
• Daysha Danyelle Moore
• Denise Moore, MSW, LCSW, LCAC
• Douglas J Moore, CSFA
• Drax James Moore, RPH
• Emily Moore
• Hannah Moore, RBT

• Speech-Language Pathologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Speech-Language Pathologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.