Individual provider Active NPI

Andrea M Moorehead, O.D.

  • Optometrist
  • Hamilton, OH
National Provider Identifier
1215027495
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
3503 Issued in OH
Practice address
1360 Eaton Ave
Hamilton, OH 45013-1407
Phone
(513) 894-1800
Fax
(513) 894-6315
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 3503 OH Primary

Addresses

Primary practice location

1360 Eaton Ave
Hamilton, OH 45013-1407

Mailing address

1360 Eaton Ave
Hamilton, OH 45013-1407
Phone (513) 894-1800

Other identifiers 1

IdentifierTypeStateIssuer
2930707MedicaidOH

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3503OHMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380240000000",
    "number": "1215027495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450131407",
            "telephone_number": "513-894-1800",
            "fax_number": "513-894-6315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1360 EATON AVE",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450131407",
            "telephone_number": "513-894-1800",
            "fax_number": "513-894-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOOREHEAD",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2013-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "OH",
            "license": "3503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2930707",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; 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.