Shantell Moore

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

213326 Issued in OK

Practice address

4400 N Lincoln Blvd
Oklahoma City, OK 73105-5108

Phone

(405) 424-7711

NPI assigned

Sep 10, 2024

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

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": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1336975036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 RENAISSANCE DR APT 411",
            "city": "NORMAN",
            "state": "OK",
            "postal_code": "730711512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 N LINCOLN BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055108",
            "telephone_number": "405-424-7711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHANTELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OK",
            "license": "213326",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Ann Moore, PA-C
• Rebecca Moore
• Robert Kevin Moore, M.D.
• Robin Lee Moore, MBS, LPC
• Sandra Louise Moore
• Stevie L Moore, B.A. PSYCHOLOGY
• Te Hara Julita Moore
• Tegan Moore, DNP, APRN, FNP-C
• Travon Moore
• Verteasta Moore

• Licensed Practical Nurse in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Licensed Practical Nurse in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.