Clifford Wayne Moore

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

633 Lashley St
Morgantown, WV 26505-2429

Phone

(304) 290-9246

NPI assigned

Aug 18, 2020

Sex

Male

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

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": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597708800000",
    "number": "1265044671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "633 LASHLEY ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052429",
            "telephone_number": "304-290-9246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "633 LASHLEY ST",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265052429",
            "telephone_number": "304-290-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CLIFFORD",
        "middle_name": "WAYNE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-18",
        "last_updated": "2020-08-18",
        "certification_date": "2020-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WV",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00805790074",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Moon, CCC-SLP
• Brandon Moore, MD
• Carrie Moore
• Carver Moore
• Charles A Moore, M.D.
• Dionna Moore, RN
• Jacqueline Dyan Moore, DO
• Jensen Moore, MS CCC-SLP
• Josephine Noelle Moore
• Kamille Destiny Moore

• Home Health Aide in Morgantown, WV
• Providers in Morgantown, WV by specialty
• Home Health Aide in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2020; 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.