Sally Jo Grenard Moore, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

23614 Issued in TX

Practice address

2901 Bee Caves Road
Box N
Austin, TX 78746-5571

Phone

(512) 329-8000

Fax

(512) 329-8299

NPI assigned

Mar 30, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Sally Jo Grenard Nesbitt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487774592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10605 SKYFLOWER DRIVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787596453",
            "telephone_number": "512-250-5974",
            "fax_number": "512-329-8299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2901 BEE CAVES ROAD",
            "address_2": "BOX N",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787465571",
            "telephone_number": "512-329-8000",
            "fax_number": "512-329-8299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENARD MOORE",
        "first_name": "SALLY",
        "middle_name": "JO",
        "name_prefix": "Mrs.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "23614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "NESBITT",
            "middle_name": "JO GRENARD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kirsten Gregurich
• Sarah Leigh Gremillion, LCSW
• Gregory S. Gremmel, MD
• Brandon Carter Gremminger, CRNA
• Kati Marie Gremminger, RDN, LD
• Chelsea Reagan Grenwelge
• Gail Gresham, IBCLC
• Gene Gordon Gress, DDS
• Steven R Gresser, CRNA
• Erich J Grethel, MD

• Psychologist in Austin, TX
• Providers in Austin, TX by specialty
• Psychologist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.