Individual provider Active NPI

Patsy Moore

  • Mental Health Counselor
  • Muskogee, OK
National Provider Identifier
1285904573
Registry record updated Jan 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1805 N York St
Suite G
Muskogee, OK 74403-1404
Phone
(918) 682-9292
NPI assigned
Jan 4, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1805 N York St
Suite G
Muskogee, OK 74403-1404

Mailing address

1805 N York St
Suite G
Muskogee, OK 74403-1404

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180319001713 OK Practitioner - Clinical Social Worker 0749542314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2011
Medicare assignment
May accept Medicare assignment
Group practices
Integrity Pathways IncGroup PAC ID 3577702653, 3 clinicians

Practice addresses (Care Compare)

814 W Okmulgee St
Muskogee, OK 74401-6839
Phone (918) 682-9292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrity Pathways Inc CurrentSince Mar 9, 2018 Accepting new patients

Locations

814 W Okmulgee St
Muskogee, OK 74401
Phone (918) 682-9292

1805 N York St
Ste G
Muskogee, OK 74403
Phone (918) 682-9292

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": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325635200000",
    "number": "1285904573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 N YORK ST",
            "address_2": "SUITE G",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 N YORK ST",
            "address_2": "SUITE G",
            "city": "MUSKOGEE",
            "state": "OK",
            "postal_code": "744031404",
            "telephone_number": "918-682-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PATSY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-04",
        "last_updated": "2012-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskogee, OK

Sources for this page

Verify at the official NPI Registry.