Katherine Ainsley Moore, CNC

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

License

1220801859

Practice address

4564 S Harvard Ave Ste B
Tulsa, OK 74135-2918

Phone

(918) 508-2220

NPI assigned

May 12, 2022

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

Other identifiers 1

Electronic endpoints 1

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": "1652313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652745600000",
    "number": "1235875196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4564 S HARVARD AVE STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352918",
            "telephone_number": "918-508-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4564 S HARVARD AVE STE B",
            "city": "TULSA",
            "state": "OK",
            "postal_code": "741352918",
            "telephone_number": "918-508-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHERINE",
        "middle_name": "AINSLEY",
        "credential": "CNC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-12",
        "last_updated": "2022-05-17",
        "certification_date": "2022-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": "1220801859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INSURANCE",
            "identifier": "T084173163",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "hello@integratedphysicalhealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4564 S Harvard Ave Ste B",
            "city": "Tulsa",
            "state": "OK",
            "country_code": "US",
            "postal_code": "741352918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Joseph P. Moore, MD
• Joseph Wayne Moore
• Joshua Moore
• Kami Opal Moore, CNS
• Kari M Moore, O.D.
• Kathryn Moore, M.S., CCC-SLP
• Katie A Moore
• Katrina Ann Moore, LPN
• Kenneth Jerald Moore, PHD LCSW
• Kera Lynn Moore

• Nutrition Education Nutritionist in Tulsa, OK
• Providers in Tulsa, OK by specialty
• Nutrition Education Nutritionist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2022; 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.