Individual provider Active NPI

Kristen Moore

  • Case Manager/Care Coordinator
  • Dublin, OH
National Provider Identifier
1215632500
Registry record updated Apr 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
525 Metro PL N Ste 300
Dublin, OH 43017-5320
Phone
(855) 289-1722
NPI assigned
Apr 4, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X CDCA.183935 OH
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

525 Metro PL N Ste 300
Dublin, OH 43017-5320

Mailing address

3210 Millicent Ave
Toledo, OH 43615-1329

Other practice location 1

2005 Ashland Ave
Toledo, OH 43620-1703
Phone (419) 841-7701

Other identifiers 1

IdentifierTypeStateIssuer
2910854MedicaidOH

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

State licenses

LicenseStateTypeSpecialty
CDCA.183935OHMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1680566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744156800000",
    "number": "1215632500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 MILLICENT AVE",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436151329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 METRO PL N STE 300",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430175320",
            "telephone_number": "855-289-1722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2005 Ashland Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436201703",
            "country_code": "US",
            "telephone_number": "419-841-7701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KRISTEN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-04-04",
        "last_updated": "2025-04-09",
        "certification_date": "2025-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "CDCA.183935",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910854",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dublin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.