Individual provider Active NPI

Ellana C Moors, ACSW, LCSW, CAP

  • Social Worker
  • Brandon, FL
National Provider Identifier
1427044478
Registry record updated Jan 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SW5385 Issued in FL
Practice address
1463 Oakfield Dr.
Suite 113
Brandon, FL 33511
Phone
(863) 248-3300
Fax
(863) 534-7028
NPI assigned
Sep 26, 2005
Last updated
Jan 18, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SW5385 FL Primary
Social Worker 104100000X 2126L FL

Addresses

Primary practice location

1463 Oakfield Dr.
Suite 113
Brandon, FL 33511

Mailing address

4422 E Columbus Dr.
Tampa, FL 33605
Phone (863) 519-0575

Other identifiers 3

IdentifierTypeStateIssuer
070869100MedicaidFL
216576000OtherFLMAGELLAN
Z2789OtherFLBCBS

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

LicenseStateTypeSpecialty
2126LFLMDSocial Worker
SW5385FLMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1427044478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4422 E COLUMBUS DR.",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33605",
            "telephone_number": "863-519-0575",
            "fax_number": "863-534-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1463 OAKFIELD DR.",
            "address_2": "SUITE 113",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "33511",
            "telephone_number": "863-248-3300",
            "fax_number": "863-534-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORS",
        "first_name": "ELLANA",
        "middle_name": "C",
        "credential": "ACSW, LCSW, CAP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-26",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "SW5385",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "FL",
            "license": "2126L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070869100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "216576000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Z2789",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 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.