Nina Moore, OT

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

104762 Issued in MN

Practice address

3800 Silver Bell Rd
Eagan, MN 55122-1653

Phone

(651) 405-0384

Fax

(952) 767-4211

NPI assigned

Sep 23, 2014

Sex

Female

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)

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.

• Advance Speech Therapy, LLC

  • Speech-Language Pathologist
  • Lino Lakes, MN
  • NPI 1215144654
  NPD

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1558763474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5710 BAKER RD",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553455901",
            "telephone_number": "952-767-4200",
            "fax_number": "952-767-4211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 SILVER BELL RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551221653",
            "telephone_number": "651-405-0384",
            "fax_number": "952-767-4211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NINA",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "MN",
            "license": "104762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Catherwood Moody, MD, MHS
• Bai Tina Moore
• Chester Lee Moore Jr., CPHT
• Christine Ann Moore, RN, CDCES
• Deanna Moore, FNP
• Patricia Moore
• Trolane Moore
• Diana C Moran, APRN, FNP-C
• Elvia G Moreta Freire, M.D.
• Tatiana Morris, LPC

• Pediatric Occupational Therapist in Eagan, MN
• Providers in Eagan, MN by specialty
• Pediatric Occupational Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.