Active NPI
Kimberlie Michele Moore, R.D.M.S.
- Sonography Radiologic Technologist
- Odessa, TX
National Provider Identifier
1356424949
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sonography Radiologic Technologist
- License
- 35049
- Practice address
- 1418 N Grant Ave
Odessa, TX 79761-2642 - Phone
- (432) 333-5100
- NPI assigned
- Oct 24, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sonography Radiologic Technologist | 2471S1302X | 35049 | TX | Primary |
Addresses
Primary practice location
1418 N Grant Ave
Odessa, TX 79761-2642
Mailing address
1418 N Grant Ave
Odessa, TX 79761-2642
Phone (432) 333-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35049 | TX | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1356424949",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1418 N GRANT AVE",
"city": "ODESSA",
"state": "TX",
"postal_code": "797612642",
"telephone_number": "432-333-5100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1418 N GRANT AVE",
"city": "ODESSA",
"state": "TX",
"postal_code": "797612642",
"telephone_number": "432-333-5100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KIMBERLIE",
"middle_name": "MICHELE",
"name_prefix": "Mrs.",
"credential": "R.D.M.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2471S1302X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Sonography",
"state": "TX",
"license": "35049",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.