Moira Elan Green

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

1555 SE Delaware Ave Ste O
Ankeny, IA 50021-4011

Phone

(515) 261-2401

NPI assigned

May 11, 2021

Last updated

May 11, 2021By 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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• KP Enterprises Iowa

  dba Axis ABA Therapy and Support Services

  • Multi-Specialty Clinic/Center
  • Ankeny, IA
  • NPI 1518478684
  NPD (past)
• KP Enterprises Iowa

  dba Axis ABA Therapy and Support Services

  • Behavior Analyst
  • Ankeny, IA
  • NPI 1659881035

  Behavior Technician

  NPD (past)

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1336723725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 CHIPPEWA TRL NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524117735",
            "telephone_number": "319-550-2129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1555 SE DELAWARE AVE STE O",
            "city": "ANKENY",
            "state": "IA",
            "postal_code": "500214011",
            "telephone_number": "515-261-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREEN",
        "first_name": "MOIRA",
        "middle_name": "ELAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@axisaba.com",
            "affiliation": "N",
            "address_1": "1555 SE Delaware Ave Ste O",
            "city": "Ankeny",
            "state": "IA",
            "country_code": "US",
            "postal_code": "500214011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Greco, PTA
• Green Valley Services LLC
• Green Valley Services LLC
• Green Valley Services LLC
• Joann S Green, MSPT
• Jenny Greenzweig, DPT
• Kathy Kay Greer, LISW
• Greg Kronenberg Crna, LLC (Alpine Pain and Regenerative Medicine)
• Gregg S Sunner, O.D., P.C.
• Marissa Gregg, DDS

• Behavior Technician in Ankeny, IA
• Providers in Ankeny, IA by specialty
• Behavior Technician in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.