Active NPI
Dennis Ray Moore, M.A., NCSP
- Psychologist
- Newtown, PA
National Provider Identifier
1255492468
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS004703L
- Practice address
- 258 South State Street
R & L Office Center
Newtown, PA 18940 - Phone
- (215) 860-2240
- Fax
- (215) 860-6778
- NPI assigned
- Dec 12, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS004703L | PA | Primary |
Addresses
Primary practice location
258 South State Street
R & L Office Center
Newtown, PA 18940
Mailing address
258 South State Street
R & L Office Center
Newtown, PA 18940
Phone (215) 860-2240
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS004703L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1255492468",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "258 SOUTH STATE STREET",
"address_2": "R & L OFFICE CENTER",
"city": "NEWTOWN",
"state": "PA",
"postal_code": "18940",
"telephone_number": "215-860-2240",
"fax_number": "215-860-6778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "258 SOUTH STATE STREET",
"address_2": "R & L OFFICE CENTER",
"city": "NEWTOWN",
"state": "PA",
"postal_code": "18940",
"telephone_number": "215-860-2240",
"fax_number": "215-860-6778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DENNIS",
"middle_name": "RAY",
"name_prefix": "Mr.",
"credential": "M.A., NCSP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-12-12",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS004703L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newtown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.