Active NPI
Kristene Y Moore, FNP-BC
- Adult Medicine Physician
- Belton, MO
National Provider Identifier
1417540402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Medicine Physician
- License
- 2012077047
- Practice address
- 105 N Park Dr
Belton, MO 64012-1957 - Phone
- (816) 694-8983
- NPI assigned
- Feb 19, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Medicine Physician | 207QA0505X | 2012077047 | MO | Primary |
Addresses
Primary practice location
105 N Park Dr
Belton, MO 64012-1957
Mailing address
105 N Park Dr
Belton, MO 64012-1957
Phone (816) 694-8983
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012077047 | MO | MD | Adult Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1613692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613692800000",
"number": "1417540402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 N PARK DR",
"city": "BELTON",
"state": "MO",
"postal_code": "640121957",
"telephone_number": "816-694-8983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N PARK DR",
"city": "BELTON",
"state": "MO",
"postal_code": "640121957",
"telephone_number": "816-694-8983"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KRISTENE",
"middle_name": "Y",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-02-19",
"last_updated": "2021-02-19",
"certification_date": "2021-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "207QA0505X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": "MO",
"license": "2012077047",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Belton, MO
- Missouri CVS Pharmacy LLC (CVS Pharmacy #16868)
- Missouri CVS Pharmacy, L.L.C. (CVS Pharmacy #05661)
- Missouri Dental Professionals, Richard Straus, D.M.D., P.C. (Dental Care on North Avenue)
- Missouri Dental Professionals, Richard Straus, DMD, PC (Belton Family Dental Care)
- Purnima Singh Mohan, MD
- Elizabeth A Morrow, PA
- Rachel Ann Murphy
- Terry L. Myers, DDS
- Venkata Vamsi Nagineni, MD
- Susan D Newton, M.A., CCC-A
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.