Wendy Richardson Moore, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

21410496 Issued in NC

Practice address

901 N Winstead Ave
Rocky Mount, NC 27804-8467

Phone

(252) 937-0215

Fax

(252) 937-2903

NPI assigned

May 13, 2019

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

Other identifiers 2

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.

• Boice-Willis Clinic PA

  • Internal Medicine Physician
  • Rocky Mount, NC
  • NPI 1699722389
  NPD (past)

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

{
    "created_epoch": "1557705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557705600000",
    "number": "1386200616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7200",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040200",
            "telephone_number": "252-937-0215",
            "fax_number": "252-937-2903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N WINSTEAD AVE",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278048467",
            "telephone_number": "252-937-0215",
            "fax_number": "252-937-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WENDY",
        "middle_name": "RICHARDSON",
        "credential": "CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-13",
        "last_updated": "2019-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "NC",
            "license": "21410496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CERTIFIED DIABETES EDUCATOR",
            "identifier": "21410496",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN",
            "identifier": "222786",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rickie Kelvin Monroe, MD
• Chevois Johnson Moore Jr., LCSW
• Julie Moore
• Kenneth Moore
• Latanya Renee Moore, LMFT
• Scott Morelli
• Emmanuel Moreno-Ortiz, PA
• Shannon Harrell Morgan, IBCLC
• Jacqueline Morrow
• Daniel Morse

• Diabetes Educator Registered Nurse in Rocky Mount, NC
• Providers in Rocky Mount, NC by specialty
• Diabetes Educator Registered Nurse in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2019; 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.