Marsha Moore

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

6906957 Issued in FL

Practice address

284 Wilmers Rd
Punta Gorda, FL 33982-8570

Phone

(941) 621-4841

NPI assigned

Aug 2, 2018

Last updated

Aug 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Canary Homes Assisted Living

  • Assisted Living Facility
  • Port Charlotte, FL
  • NPI 1972448959
  NPD Authorized official

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1639657570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "284 WILMERS RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339828570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "284 WILMERS RD",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339828570",
            "telephone_number": "941-621-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "FL",
            "license": "6906957",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FB",
            "identifier": "20904383",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacob Moenning
• Michelle Walbert Moenning, DDS
• Siddique Rezan Mohammed
• Molecular Imaging of Florida PLLC
• Fabrizio Monge, M.D.
• Kathia Morales-Rivera
• Astrid Morales, O.T.
• Marla J Moseley, CRNA
• John A Moss, MD
• Yasser Mostafa, PHYSICAL THERAPIST

• Adult Care Home Facility in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Adult Care Home Facility in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.