Shannan Gabriella Moore

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

RS2025-0059 Issued in NM

Practice address

Msc11 6052 1 University of New Mexico
Albuquerque, NM 87131-0001

Phone

(505) 272-6120

NPI assigned

May 15, 2020

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 NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1316569031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MSC11 6052 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-6120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MSC11 6052 1 UNIVERSITY OF NEW MEXICO",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871310001",
            "telephone_number": "505-272-6120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANNAN",
        "middle_name": "GABRIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NM",
            "license": "RS2025-0059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Reginald Wayne Moore
• Robert Lynn Moore, PHARM.D., PH.C.
• Roxi Moore, LCSW
• Sarah Ann Moore, MD
• Sean Alexander Moore, DDS
• Thomas G Moore
• Timothy S Moore
• Wendeja Moore, LMSW
• Megan L Moorhead, MD
• Alexa Rachel Moorman, PHYSICIAN ASSISTANT

• Student in an Organized Health Care Education/Training Program in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Student in an Organized Health Care Education/Training Program in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.