McKenzie Moore, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AL4252 Issued in FL

Practice address

615 Vonderburg Dr
Brandon, FL 33511-5972

Phone

(813) 684-2663

NPI assigned

Oct 17, 2019

Sex

Female

Sole proprietor

Yes

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

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1326680703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115972",
            "telephone_number": "813-684-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 VONDERBURG DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335115972",
            "telephone_number": "813-684-2663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MCKENZIE",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "FL",
            "license": "AL4252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Monteleone, LMHC, LMFT
• Love Shareese Montgomery, HHA
• Monther Al-Halawani, MD, PA (Center for Diabetes and Metabolic Disorders)
• Camila Montiel Acuna
• Brittany Mooney, SLP-CF
• Nakeeta Moore
• Yovonda Moore
• Ellana C Moors, ACSW, LCSW, CAP
• Rathinam Krishna Moorthy, MD
• Claudia Mora, LMFT

• Athletic Trainer in Brandon, FL
• Providers in Brandon, FL by specialty
• Athletic Trainer in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.