Keionna Moore

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN.142798.MEDS.IV Issued in OH

Practice address

421 Southern Blvd NW Apt 104
Warren, OH 44485-2564

Phone

(330) 766-7355

NPI assigned

Apr 12, 2022

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

Practice roles

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.

• Midwest Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1255852992
  NPD (past)
• Midwest Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1407326366
  NPD (past)
• Midwest Recovery Center LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Toledo, OH
  • NPI 1598242281
  NPD (past)
• Valor Recovery Center of Youngstown LLC

  • Substance Abuse Rehabilitation Facility
  • Austintown, OH
  • NPI 1366912933
  NPD (past)
• Valor Recovery Center of Youngstown LLC

  • Substance Abuse Rehabilitation Facility
  • Cincinnati, OH
  • NPI 1598530701
  NPD (past)

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

{
    "created_epoch": "1649721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649721600000",
    "number": "1346982097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SOUTHERN BLVD NW APT 104",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444852564",
            "telephone_number": "330-766-7355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SOUTHERN BLVD NW APT 104",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444852564",
            "telephone_number": "330-766-7355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEIONNA",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-12",
        "last_updated": "2022-04-12",
        "certification_date": "2022-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "LPN.142798.MEDS.IV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian D Moore
• Angelique Moore, RN
• Cassie Jo Moore, CDC-A
• Jackee Nikita Moore
• Kashmere Moore
• Linda Moore, CDMS, CCM
• Maryjoe Moore
• Sharonda Monique Moore, LPN
• Tarche' Moore
• Taren Lynn Moore

• Licensed Practical Nurse in Warren, OH
• Providers in Warren, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2022; 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.