Individual provider Active NPI

Natashia Sunita Moore, LCSW

  • Clinical Social Worker
  • Mansfield, TX
National Provider Identifier
1386218758
Registry record updated May 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
56881 Issued in TX
Practice address
301 Rock Meadow TRL
Mansfield, TX 76063-4850
Phone
(214) 235-9263
NPI assigned
May 19, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 19, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 56881 TX Primary

Addresses

Primary practice location

301 Rock Meadow TRL
Mansfield, TX 76063-4850

Mailing address

301 Rock Meadow TRL
Mansfield, TX 76063-4850
Phone (214) 235-9263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220519000543 IA Practitioner - Clinical Social Worker 8628467115 Reassigns benefits to 1 organization
I20220527001770 IL Practitioner - Clinical Social Worker 8628467115 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
56881TXMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Care, Inc CurrentSince Jun 1, 2022 Accepting new patients
Community Health Care, Inc. CurrentSince Jun 1, 2022 Accepting new patients
Community Health Care Inc CurrentSince Jun 1, 2022 Accepting new patients
Community Health Care, Inc. Current Accepting new patients
Community Health Care, Inc. Current Accepting new patients

Locations

500 W River Dr
Davenport, IA 52801
Phone (563) 327-2035

2750 11th St
Rock Island, IL 61201
Phone (563) 327-2000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621382400000",
    "number": "1386218758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ROCK MEADOW TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634850",
            "telephone_number": "214-235-9263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ROCK MEADOW TRL",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760634850",
            "telephone_number": "214-235-9263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NATASHIA",
        "middle_name": "SUNITA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2021-05-19",
        "certification_date": "2021-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "56881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.