Rodney Wayne Moore, RN BSN CPAN CAPA

Primary specialty

Ambulatory Care Registered NurseTaxonomy code 163WP2201X

License

082489 Issued in MO

Practice address

1078 Fontaine PL
Saint Louis, MO 63137-1705

Phone

(404) 918-0461

Fax

(314) 868-6605

NPI assigned

Sep 9, 2009

Last updated

Sep 9, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Mr. Rodney Wayne Moore Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor on Science - Nursing, Registered Nurse

State licenses

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252454400000",
    "number": "1548593536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1078 FONTAINE PL.",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "63137",
            "telephone_number": "404-918-0461",
            "fax_number": "314-868-6605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1078 FONTAINE PL",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631371705",
            "telephone_number": "404-918-0461",
            "fax_number": "314-868-6605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RODNEY",
        "middle_name": "WAYNE",
        "name_prefix": "Mr.",
        "credential": "RN BSN CPAN CAPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-09-09",
        "last_updated": "2009-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "MO",
            "license": "082489",
            "primary": true
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "GA",
            "license": "RN084407",
            "primary": false
        },
        {
            "code": "163WP2201X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Ambulatory Care",
            "state": "FL",
            "license": "RN9272235",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RODNEY",
            "last_name": "MOORE",
            "middle_name": "WAYNE",
            "prefix": "MR.",
            "credential": "RN BSN CPAN CAPA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Nikitsha L Moore, RN MSN
• Richelle Moore, M.ED., PLPC, NCC
• Richelle D Moore, RN
• Robert M Moore, DPM
• Robert P Moore, MD
• Samantha Moore, M.S. CF-SLP
• Sara Garland Moore, ACNP
• Sharon Rae Moore, MSW, LCSW
• Stephanie Gelaine Moore, LPC
• Steven Robert Moore

• Ambulatory Care Registered Nurse in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Ambulatory Care Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2009; 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.