Stacy M Moore

Primary specialty

Audiologist-Hearing Aid FitterTaxonomy code 237600000X

License

1601000313 Issued in MI

Practice address

4369 Miller Rd
Flint, MI 48507-1279

Phone

(810) 733-1385

Fax

(810) 733-7893

NPI assigned

Jun 10, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231891200000",
    "number": "1386685121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 406153",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303841876",
            "telephone_number": "800-528-3277",
            "fax_number": "888-888-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4369 MILLER RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071279",
            "telephone_number": "810-733-1385",
            "fax_number": "810-733-7893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STACY",
        "middle_name": "M",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-10",
        "last_updated": "2009-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "12046396",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "3501003257",
            "primary": false
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "MI",
            "license": "1601000313",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386685121",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Makiah Moore
• Marci Moore
• Robert Joseph Moore, M.S
• Rose M Moore, BA
• Savannah Leigh Moore
• Susan Moore, LLMSW
• Travis Moore
• Mahloriy Moorer
• Nikki Lynn Moorman, LPC
• Alicia Marie Morales

• Audiologist-Hearing Aid Fitter in Flint, MI
• Providers in Flint, MI by specialty
• Audiologist-Hearing Aid Fitter in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2009; 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.