Brenna Moore

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

37600 Issued in NE

Practice address

625 W William Ave Ste 100
North Platte, NE 69101-0026

Phone

(308) 568-3580

NPI assigned

Mar 21, 2023

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

• Brenna Wyson Former name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1528760733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 W WILLIAM AVE STE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010026",
            "telephone_number": "308-568-3580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 W WILLIAM AVE STE 100",
            "city": "NORTH PLATTE",
            "state": "NE",
            "postal_code": "691010026",
            "telephone_number": "308-568-3580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "37600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENNA",
            "last_name": "WYSON",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Collin Monty, DPT
• Edwin Monuki, MD
• Mary Elizabeth Moody
• Hunyoung Moon
• Lauren Haekyung Quy Moon
• Isis Sherae/Kola Moore
• Jacqueline Jovon Moore
• Kendra Moore
• Kerry Lynn Moore, LCSW
• Lisa Moore

• Student in an Organized Health Care Education/Training Program in Orange, CA
• Providers in Orange, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.