Al Moore

Primary specialty

Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X

License

RN.524900 Issued in OH

Practice address

1757 Indian Wood Cir
Maumee, OH 43537-4009

Phone

(419) 273-6820

NPI assigned

Mar 4, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Midwest Detox Center LLC

  • Substance Abuse Rehabilitation Facility
  • Maumee, OH
  • NPI 1003337734
  NPD (past)
• Midwest Detox Center LLC

  • Substance Abuse Rehabilitation Facility
  • Maumee, OH
  • NPI 1033608195
  NPD (past)

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

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1548027717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "543 NICHOLAS ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436092917",
            "telephone_number": "419-973-7766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 INDIAN WOOD CIR",
            "city": "MAUMEE",
            "state": "OH",
            "postal_code": "435374009",
            "telephone_number": "419-273-6820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "RN.524900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anastasia Molina
• Peggy Moll, LPN
• Monclova Road Pediatrics
• Brittney Mong, RBT
• Bruce A Montgomery, DO
• Arianne M Moore
• Bailey Nicole Moore, CDCA
• Delores Regina Moore, LICDC
• Rachel M Moore
• Richard Morely

• Addiction (Substance Use Disorder) Registered Nurse in Maumee, OH
• Providers in Maumee, OH by specialty
• Addiction (Substance Use Disorder) Registered Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.