Amy Jo Moore

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

28229536A Issued in IN

Practice address

1332 Waterford Cir
Goshen, IN 46526-6009

Phone

(574) 534-3920

NPI assigned

Jul 15, 2021

Last updated

Jul 15, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1295307510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 E BEARDSLEY AVE",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465143504",
            "telephone_number": "574-343-4038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1332 WATERFORD CIR",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266009",
            "telephone_number": "574-534-3920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMY",
        "middle_name": "JO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-15",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "IN",
            "license": "28229536A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "amy.moore@waterfordcrossingsl.com",
            "affiliation": "N",
            "endpointDescription": "Practice E-mail",
            "address_1": "1332 Waterford Cir",
            "city": "Goshen",
            "state": "IN",
            "country_code": "US",
            "postal_code": "465266009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Justine Brook Miller, MA, RDN, CD
• Karissa Miller, MSW
• Leah R Miller, N.P.
• Lexi Miller, DC
• Matthew R Misner, D.O.
• David Moore, LCSW
• Emily Marie Moore, N.D.
• Janice Moore, CRNA
• Julie Ann Moore, PMHNP
• Kevin Moore, MSW, LCSW

• Gerontology Registered Nurse in Goshen, IN
• Providers in Goshen, IN by specialty
• Gerontology Registered Nurse in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.