Kelli Michelle Moore, CTRS

Primary specialty

Recreation TherapistTaxonomy code 225800000X

Practice address

1 Freedom Way
Recreation Therapy (294)
Augusta, GA 30904-6258

Phone

(706) 733-0188

NPI assigned

Jul 26, 2006

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184025600000",
    "number": "1225051469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 WATSON BAILEY RD",
            "city": "HARLEM",
            "state": "GA",
            "postal_code": "308143910",
            "telephone_number": "706-556-1410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 FREEDOM WAY",
            "address_2": "RECREATION THERAPY (294)",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309046258",
            "telephone_number": "706-733-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KELLI",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "CTRS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2007-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliott Matthew Moore
• Fletcher Stuart Moore, M.D.
• Gabrielle Mara Moore, MD
• Jacelyn Jenise Moore, RBT
• John Michael Moore, LAPC
• Laura Moore, M.ED. CCC-SLP
• Lindsay Moore, NP
• Nicole Moore, RD
• Rebecca L Moore, LCSW
• Savannah Moore

• Recreation Therapist in Augusta, GA
• Providers in Augusta, GA by specialty
• Recreation Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 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.