Active NPI
Avie B. Moore, COTA
- Occupational Therapy Assistant
- Pueblo, CO
National Provider Identifier
1518256882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 234835
- Practice address
- 1071 Eagleridge Blvd.
Pueblo, CO 81008 - Phone
- (719) 583-0832
- Fax
- (719) 583-0797
- NPI assigned
- Apr 7, 2011
- 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 |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 234835 | CO | Primary |
Addresses
Primary practice location
1071 Eagleridge Blvd.
Pueblo, CO 81008
Mailing address
8540 Scarborough Dr.
Suite 200
Colo Springs, CO 80920
Phone (719) 630-7500
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 |
|---|---|---|---|
| 234835 | CO | MD | Occupational Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wsi | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Nursing Care Agency
- Colorado Springs, CO
- NPI 1023317385
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302134400000",
"number": "1518256882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8540 SCARBOROUGH DR.",
"address_2": "SUITE 200",
"city": "COLO SPRINGS",
"state": "CO",
"postal_code": "80920",
"telephone_number": "719-630-7500",
"fax_number": "719-630-8099"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1071 EAGLERIDGE BLVD.",
"city": "PUEBLO",
"state": "CO",
"postal_code": "81008",
"telephone_number": "719-583-0832",
"fax_number": "719-583-0797"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "AVIE",
"middle_name": "B.",
"name_prefix": "Mrs.",
"credential": "COTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-04-07",
"last_updated": "2011-04-07",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "CO",
"license": "234835",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pueblo, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.