Active NPI
Christopher Moore
- Behavior Technician
- Las Vegas, NV
National Provider Identifier
1497107726
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- License
- 16-21212
- Practice address
- 630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849 - Phone
- (702) 998-9505
- NPI assigned
- Jul 11, 2016
- Last updated
- May 3, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | RBT-16-21212 | NV | |
| Behavior Technician | 106S00000X | 16-21212 | NV | Primary |
Addresses
Primary practice location
630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849
Mailing address
630 S Rancho Dr Ste a
Las Vegas, NV 89106-4849
Phone (702) 998-9505
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 |
|---|---|---|---|
| RBT-16-21212 | NV | MD | Behavioral Analyst |
| 16-21212 | NV | MD | Behavior Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620000000000",
"number": "1497107726",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 S RANCHO DR STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064849",
"telephone_number": "702-998-9505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 S RANCHO DR STE A",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891064849",
"telephone_number": "702-998-9505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CHRISTOPHER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-07-11",
"last_updated": "2021-05-03",
"certification_date": "2021-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": "NV",
"license": "RBT-16-21212",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "NV",
"license": "16-21212",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 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.