Active NPI
Kelly R. Moore, LSCSW
- Social Worker
- Lenexa, KS
National Provider Identifier
1366880809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 4470
- Practice address
- 11261 Strang Line Rd
Lenexa, KS 66215-4040 - Phone
- (913) 353-6021
- NPI assigned
- Jun 6, 2013
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 4470 | KS | Primary |
Addresses
Primary practice location
11261 Strang Line Rd
Lenexa, KS 66215-4040
Mailing address
13217 W 107TH Ter
Lenexa, KS 66210-3726
Phone (913) 963-7751
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 |
|---|---|---|---|
| 4470 | KS | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1370476800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699920000000",
"number": "1366880809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13217 W 107TH TER",
"city": "LENEXA",
"state": "KS",
"postal_code": "662103726",
"telephone_number": "913-963-7751"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11261 STRANG LINE RD",
"city": "LENEXA",
"state": "KS",
"postal_code": "662154040",
"telephone_number": "913-353-6021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KELLY",
"middle_name": "R.",
"name_prefix": "Ms.",
"credential": "LSCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-06",
"last_updated": "2023-11-14",
"certification_date": "2023-11-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "KS",
"license": "4470",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lenexa, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.