Deshawna Laniece Moore, INDEPENDENT PROVIDER

Primary specialty

Home Health AideTaxonomy code 374U00000X

Practice address

2041 Hampstead Dr S
Columbus, OH 43229-2760

Phone

(614) 916-6314

NPI assigned

Feb 12, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

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": "1549929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549929600000",
    "number": "1306302641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 HAMPSTEAD DR S",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292760",
            "telephone_number": "614-916-6314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 HAMPSTEAD DR S",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432292760",
            "telephone_number": "614-916-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DESHAWNA",
        "middle_name": "LANIECE",
        "credential": "INDEPENDENT PROVIDER",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "376J00000X",
            "taxonomy_group": "",
            "desc": "Homemaker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0082958",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SUPPLIER ID",
            "identifier": "0000190120",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Connor Ian Moore
• Constance R Moore, APRN-CRNA
• Courtenay Kathryn Moore, MD
• David Moore, M.D.
• Deasia Moore
• Diane Moore, STNA
• Elenora Moore, RN
• Erin N Moore, R.N.
• Heidi Moore
• Isabelle Ann Moore

• Home Health Aide in Columbus, OH
• Providers in Columbus, OH by specialty
• Home Health Aide in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; 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.