Active NPI
Michele Moore, RD
- Registered Dietitian
- Harrisburg, PA
National Provider Identifier
1215979299
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 504822
- Practice address
- 101 Washignton Street
Harrisburg, PA 17104-1612 - Phone
- (717) 221-6258
- Fax
- (717) 657-7390
- NPI assigned
- Jun 12, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | DN001736 | PA | |
| Registered Dietitian | 133V00000X | 504822 | PA | Primary |
Addresses
Primary practice location
101 Washignton Street
Harrisburg, PA 17104-1612
Mailing address
409 S 2ND St
Suite 2F
Harrisburg, PA 17104-1612
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1016757810003 | Medicaid | PA | |
| 7574341 | Other | AETNA | |
| 2818240 | Other | AETNA HMO | |
| DN001736 | Other | PA | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 504822 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upmc Pinnacle Hospitals | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Harrisburg, PA
- NPI 1407813603
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150070400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1465516800000",
"number": "1215979299",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "409 S 2ND ST",
"address_2": "SUITE 2F",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171041612"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WASHIGNTON STREET",
"city": "HARRISBURG",
"state": "PA",
"postal_code": "171041612",
"telephone_number": "717-221-6258",
"fax_number": "717-657-7390"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MICHELE",
"name_prefix": "Ms.",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-12",
"last_updated": "2016-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "PA",
"license": "DN001736",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "504822",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1016757810003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7574341",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2818240",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "DN001736",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harrisburg, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.