Active NPI
Kevin R Moore
- Case Manager/Care Coordinator
- Coral Springs, FL
National Provider Identifier
1619040037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 10528 NW 57TH CT
Coral Springs, FL 33076-2810 - Phone
- (954) 825-8302
- Fax
- (954) 345-3789
- NPI assigned
- Nov 15, 2006
- Last updated
- Jul 9, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | FL | Primary | |
| Case Manager/Care Coordinator | 171M00000X | FL |
Addresses
Primary practice location
10528 NW 57TH CT
Coral Springs, FL 33076-2810
Mailing address
10528 NW 57TH CT
Coral Springs, FL 33076-2810
Phone (954) 825-8302
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
| License | State | Type | Specialty |
|---|---|---|---|
| 690453096 | FL | MD | Case Manager/Care Coordinator |
| 690453098 | FL | MD | Case Manager/Care Coordinator |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1619040037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10528 NW 57TH CT",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330762810",
"telephone_number": "954-825-8302",
"fax_number": "954-345-3789"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10528 NW 57TH CT",
"city": "CORAL SPRINGS",
"state": "FL",
"postal_code": "330762810",
"telephone_number": "954-825-8302",
"fax_number": "954-345-3789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "KEVIN",
"middle_name": "R",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "FL",
"license": null,
"primary": true
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": "FL",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Coral Springs, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.