Latecka S Moore

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

CO133923 Issued in GA

Practice address

147 E Montgomery XRD
Savannah, GA 31406-4730

Phone

(912) 201-1701

NPI assigned

Oct 17, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Luxe the Salon

  • Specialist
  • Savannah, GA
  • NPI 1679374060
  NPD

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

{
    "created_epoch": "1697500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742860800000",
    "number": "1528840428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 E MONTGOMERY XRD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064730",
            "telephone_number": "912-201-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 E MONTGOMERY XRD",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314064730",
            "telephone_number": "912-201-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LATECKA",
        "middle_name": "S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-17",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": "CO133923",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "GA",
            "license": "CO133923",
            "primary": false
        },
        {
            "code": "225000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthotic Fitter",
            "state": "GA",
            "license": "CO133923",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "GA",
            "license": "CO133923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hayley Moore, FNP-C
• James David Moore Jr., DDS
• John Holland Moore, MD
• Khailyla Moore, RBT
• Khalilaah S Moore
• Lysbeth Irene Moore, MA., LPC
• Meghan Blevens Moore, OTR/L
• Riley Moore
• Stephanie Alice Moore, RD
• Wistar Moore III, M.D.

• Durable Medical Equipment & Medical Supplies in Savannah, GA
• Providers in Savannah, GA by specialty
• Durable Medical Equipment & Medical Supplies in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; 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.