Jorge Avitia-Moreno

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

License

K03-43-5660 Issued in KS

Practice address

11601 W Stanley Draper Dr
Oklahoma City, OK 73165-6503

Phone

(405) 799-7540

NPI assigned

Feb 26, 2025

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760918400000",
    "number": "1528865672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11601 W STANLEY DRAPER DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731656503",
            "telephone_number": "405-799-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11601 W STANLEY DRAPER DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731656503",
            "telephone_number": "405-799-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVITIA-MORENO",
        "first_name": "JORGE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-10-20",
        "certification_date": "2025-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KS",
            "license": "K03-43-5660",
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Manager/Care Coordinator in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Case Manager/Care Coordinator in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.