Brian David Moore, BA, BHRS

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

RT 1, Box 35D
Boley, OK 74829

Phone

(918) 667-3367

Fax

(918) 667-3387

NPI assigned

Oct 31, 2012

Sex

Male

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

Credentials

Bachelor of Arts

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.

• Stepping Stones, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boley, OK
  • NPI 1508865841
  NPD (past)
• Stepping Stones, Inc.

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Boley, OK
  • NPI 1649360025
  NPD (past)

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1396099271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 218",
            "city": "BOLEY",
            "state": "OK",
            "postal_code": "748290218",
            "telephone_number": "918-667-3367",
            "fax_number": "918-667-3387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RT 1, BOX 35D",
            "city": "BOLEY",
            "state": "OK",
            "postal_code": "74829",
            "telephone_number": "918-667-3367",
            "fax_number": "918-667-3387"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIAN",
        "middle_name": "DAVID",
        "credential": "BA, BHRS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-31",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100685660A",
            "state": "OK"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100685660D",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Elizabeth Kincade, LPC, NCC
• Jonathan Paul Looney
• Donna Danelle Magness, MS, LPC CANDIDATE
• Zondra Magness
• Angela Diane Miller Mack
• Lisa Moore
• Tami Morgan, MS, PSRS
• Lavada Stacy Myers, BS
• Gaylen L. Newton, RN
• Randy Norman, MS, BHRS

• Case Manager/Care Coordinator in Boley, OK
• Providers in Boley, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.