Individual provider Active NPI

Fantasia Moore

  • Transportation Network Company
  • Grand Prairie, TX
National Provider Identifier
1558218107
Registry record updated Mar 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Transportation Network CompanyTaxonomy code 342000000X
License
29101352 Issued in TX
Practice address
2609 Carrington LN
Grand Prairie, TX 75052-4005
Phone
(469) 264-1626
NPI assigned
Mar 12, 2026
Last updated
Mar 12, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Network Company 342000000X 29101352 TX Primary

Addresses

Primary practice location

2609 Carrington LN
Grand Prairie, TX 75052-4005

Mailing address

2609 Carrington LN
Grand Prairie, TX 75052-4005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
29101352TXMDTransportation Network Company

NPI Registry JSON

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

{
    "created_epoch": "1773273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773273600000",
    "number": "1558218107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2609 CARRINGTON LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2609 CARRINGTON LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750524005",
            "telephone_number": "469-264-1626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "FANTASIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-12",
        "last_updated": "2026-03-12",
        "certification_date": "2026-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "342000000X",
            "taxonomy_group": "",
            "desc": "Transportation Network Company",
            "state": "TX",
            "license": "29101352",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; 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.