Wanda Terrell Moore- Wilson, MB&C, CNA,MOA

Primary specialty

Health Information TechnicianTaxonomy code 247000000X

Practice address

5612 S Wabash Ave # Apty5
Chicago, IL 60637-1155

Phone

(312) 481-3779

NPI assigned

Jul 22, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700352000000",
    "number": "1437722949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5612 S WABASH AVE APT 5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371155",
            "telephone_number": "312-481-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5612 S WABASH AVE # APTY5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371155",
            "telephone_number": "312-481-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE- WILSON",
        "first_name": "WANDA",
        "middle_name": "TERRELL",
        "name_prefix": "Mrs.",
        "credential": "MB&C, CNA,MOA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-11-19",
        "certification_date": "2023-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247000000X",
            "taxonomy_group": "",
            "desc": "Technician, Health Information",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "CHICAGO",
            "affiliation": "N",
            "endpointDescription": "CHICAGO",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "5612 S Wabash Ave Apt 5",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606371155",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Moore Associates in Womens Health
• Betty Moore Carter, CADC BSW MA ED
• Nyla Moore Jackson
• Shelagh M. Moore Jaworski, LCSW
• Kaitlin Elizabeth Moore Morley
• Edna Faye Moore-Burke, CNP, MS, RN
• Leslie Dy-Anne Moore-Hicks, CNM
• Deborah Marie Moore-Thompson
• Candice C Moore-Udogu, RN
• Abigail Moore

• Health Information Technician in Chicago, IL
• Providers in Chicago, IL by specialty
• Health Information Technician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2023; 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.