Michelle Bacon Moore, PSY.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

Practice address

3450 Chestnut St
3Rd Floor
New Orleans, LA 70115-2443

Phone

(504) 412-1580

NPI assigned

Nov 22, 2008

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

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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 and National Provider Directory roles.

• Louisiana State University School of Medicine in New Orleans Faculty G

  • Multi-Specialty Clinic/Center
  • New Orleans, LA
  • NPI 1477582526
  Medicare reassignment NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  • Durable Medical Equipment & Medical Supplies
  • Kenner, LA
  • NPI 1316417629
  NPD
• Louisiana State University School of Medicine in New Orleans Faculty G

  • Dentist
  • New Orleans, LA
  • NPI 1740534064
  NPD

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

{
    "created_epoch": "1227312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1336394097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62243",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701622243",
            "telephone_number": "504-412-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 CHESTNUT ST",
            "address_2": "3RD FLOOR",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701152443",
            "telephone_number": "504-412-1580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHELLE",
        "middle_name": "BACON",
        "name_prefix": "Ms.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-22",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelli Moore
• Kevin T Moore
• Mary Katherine Moore
• Merrick Moore
• Michele R Moore
• Sean Michael Moore, MD
• Sean Patrick Moore, PLPC
• Shawanda Moore
• Shelby Claire Moore, BA
• Tanisha Moore

• Clinical Child & Adolescent Psychologist in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Clinical Child & Adolescent Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.