Active NPI
Alyssa Ann Moore, RD
- Registered Dietitian
- Dallas, TX
National Provider Identifier
1609686047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DT91731
- Practice address
- 17060 Dallas Pkwy Ste 112
Dallas, TX 75248-1905 - Phone
- (469) 372-2022
- Fax
- (833) 290-5413
- NPI assigned
- Jan 8, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DT91731 | TX | Primary |
Addresses
Primary practice location
17060 Dallas Pkwy Ste 112
Dallas, TX 75248-1905
Mailing address
17060 Dallas Pkwy Ste 112
Dallas, TX 75248-1905
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17060 Dallas Pkwy
Suite 112
Dallas, TX 75248-1905
Phone (469) 372-2022
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DT91731 | TX | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Doherty Nutrition LLC | Dietitian, Registered | Current | Accepting new patients |
Locations
17060 Dallas Pkwy
Ste 112
Dallas, TX 75248
Phone (469) 372-2022
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736294400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736294400000",
"number": "1609686047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17060 DALLAS PKWY STE 112",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17060 DALLAS PKWY STE 112",
"city": "DALLAS",
"state": "TX",
"postal_code": "752481905",
"telephone_number": "469-372-2022",
"fax_number": "833-290-5413"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ALYSSA",
"middle_name": "ANN",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-08",
"last_updated": "2025-01-08",
"certification_date": "2025-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "TX",
"license": "DT91731",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.