Individual provider Active NPI

Zella Moore, NP

  • Marriage & Family Therapist
  • Warm Springs, OR
National Provider Identifier
1285747816
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
309003036 Issued in IL
Practice address
1270 Kot-Num Rd Box C
Warm Springs, OR 97761-3001
Phone
(815) 353-5943
Fax
(541) 553-2457
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 01050215NP OR
Marriage & Family Therapist 106H00000X 309003036 IL Primary

Addresses

Primary practice location

1270 Kot-Num Rd Box C
Warm Springs, OR 97761-3001

Mailing address

1639 N Alpine Rd
Suite 260
Rockford, IL 61107-1449
Phone (815) 395-1500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061026000243 IL Practitioner - Nurse Practitioner 8123025673 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
309003036ILMDMarriage & Family Therapist
01050215NPORMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
BHC Streamwood Hospital Inc. CurrentSince Jun 22, 2019 Accepting new patients

Locations

1400 E Irving Park Rd
Streamwood, IL 60107
Phone (630) 483-5578

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.

NPI Registry JSON

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1285747816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1639 N ALPINE RD",
            "address_2": "SUITE 260",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611071449",
            "telephone_number": "815-395-1500",
            "fax_number": "815-395-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 KOT-NUM RD BOX C",
            "city": "WARM SPRINGS",
            "state": "OR",
            "postal_code": "977613001",
            "telephone_number": "815-353-5943",
            "fax_number": "541-553-2457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ZELLA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "OR",
            "license": "01050215NP",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "309003036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warm Springs, OR

Sources for this page

Verify at the official NPI Registry.