Eileen M. Moore, APRN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

001598 Issued in CT

Practice address

108 New London Tpke
Norwich, CT 06360-2645

Phone

(860) 889-3052

Fax

(860) 889-0926

NPI assigned

Jan 29, 2007

Last updated

Mar 19, 2016By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Norwich Psychiatric Center

  • Psychiatric/Mental Health Nurse Practitioner
  • Norwich, CT
  • NPI 1518003680
  NPD (past)

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458345600000",
    "number": "1588700538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602645",
            "telephone_number": "860-889-3052",
            "fax_number": "860-889-0926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 NEW LONDON TPKE",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063602645",
            "telephone_number": "860-889-3052",
            "fax_number": "860-889-0926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EILEEN",
        "middle_name": "M.",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2016-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CT",
            "license": "001598",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004183365",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APRN LICENSE NUMBER",
            "identifier": "001598",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mohan & Virani DDS, LLC
• Cheryl Ann Molina, MA, LPC
• Gerald Michael Monahan, LMT
• Mary Louise Montany, LCSW
• David Moore II, MSW
• Katherine K Moore, LCSW
• Meredith Moore
• Christin Michele Morales, LPC
• Angela Morgan, LCSW
• Ashley Marie Morgan

• Psychiatric/Mental Health Nurse Practitioner in Norwich, CT
• Providers in Norwich, CT by specialty
• Psychiatric/Mental Health Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.