Elizabeth Marie Moore – Home Health Agency

Key facts

NPI: 1376137448
Entity type: Individual (NPI type 1)
Primary specialty: Home Health Agency 251E00000X
Practice address: 14565 State Route 93
Pedro, OH 45659-8702
Phone: (740) 442-8189
NPI assigned: Mar 1, 2021
Sex: Female
Sole proprietor: Yes

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Home Health Agency	251E00000X			Yes

Addresses

Primary practice location

14565 State Route 93
Pedro, OH 45659-8702

Mailing address

14565 State Route 93
Pedro, OH 45659-8702
Phone (740) 442-8189

Other identifiers

Identifier	Type	State	Issuer
2672497	Medicaid	OH

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 1, 2021.

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1376137448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14565 STATE ROUTE 93",
            "city": "PEDRO",
            "state": "OH",
            "postal_code": "456598702",
            "telephone_number": "740-442-8189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14565 STATE ROUTE 93",
            "city": "PEDRO",
            "state": "OH",
            "postal_code": "456598702",
            "telephone_number": "740-442-8189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "middle_name": "MARIE",
        "credential": "HOME HEALTH AID",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2672497",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pedro, OH

All providers in Pedro, OH · Home Health Agency in Ohio

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 1, 2021. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.