Active NPI
Kristin Delagrange Moore, AUD
- Audiologist
- Charlotte, NC
National Provider Identifier
1528230778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 4805
- Practice address
- 4421 Stuart Andrew Blvd
Charlotte, NC 28217-1589 - Phone
- (980) 343-6960
- NPI assigned
- Mar 27, 2008
- 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 4805 | NC | Primary |
Addresses
Primary practice location
4421 Stuart Andrew Blvd
Charlotte, NC 28217-1589
Mailing address
1025 Anduin Falls Dr
Charlotte, NC 28269-7004
Phone (980) 343-5455
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| SAN080 | Medicaid | SC | |
| 9195272 | Other | NC | AETNA |
| 1628V | Other | NC | BCBSNC |
| 7413387 | Medicaid | NC | |
| 30106724 | Other | SC | SELECT HEALTH OF SC |
| 6798431 | Other | NC | CIGNA |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4805 | NC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Charlotte Eye Ear Nose & Throat Associates, P.a. | Audiologist | 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.
-
- Ophthalmology Physician
- Charlotte, NC
- NPI 1043287469
Audiologist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1781049600000",
"number": "1528230778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 ANDUIN FALLS DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282697004",
"telephone_number": "980-343-5455",
"fax_number": "980-343-2451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4421 STUART ANDREW BLVD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282171589",
"telephone_number": "980-343-6960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KRISTIN",
"middle_name": "DELAGRANGE",
"name_prefix": "Ms.",
"credential": "AUD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-03-27",
"last_updated": "2026-06-10",
"certification_date": "2026-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "NC",
"license": "4805",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "SAN080",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "9195272",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "1628V",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "7413387",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SELECT HEALTH OF SC",
"identifier": "30106724",
"state": "SC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6798431",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.