Mikayla Lee Moore

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OT-A1862 Issued in AR

Practice address

5532 JFK Blvd
North Little Rock, AR 72116-6708

Phone

(501) 588-3211

NPI assigned

Aug 5, 2022

Last updated

Aug 8, 2022By 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

Medicare fee-for-service enrollment

Enrolled in AR

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Allied Therapy and Consulting Services, PA

  • Specialist
  • North Little Rock, AR
  • NPI 1134185937
  Medicare reassignment NPD
• Beyond Boundaries, Inc

  • Physical Therapist
  • Ward, AR
  • NPI 1134355043
  NPD (past)

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1295462646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5532 JFK BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166708",
            "telephone_number": "501-588-3211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5532 JFK BLVD",
            "city": "NORTH LITTLE ROCK",
            "state": "AR",
            "postal_code": "721166708",
            "telephone_number": "501-588-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MIKAYLA",
        "middle_name": "LEE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "AR",
            "license": "OT-A1862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eugene Moore
• Ian J Moore, PHD, LP
• Joellen Moore
• Justin Todd Moore
• M Susan Moore, LCSW
• Phaedra Annetionette Moore
• Samuel Arden Moore, D.O.
• Shelly Moore
• Stacey Hurst Moore, LPC
• Terry A Moore, RDH

• Occupational Therapy Assistant in North Little Rock, AR
• Providers in North Little Rock, AR by specialty
• Occupational Therapy Assistant in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.