Brandon Ray Moore

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

TCA906 Issued in KY

Practice address

333 Thomas More Pkwy
Crestview Hills, KY 41017-3428

Phone

(858) 341-5800

NPI assigned

Oct 5, 2020

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1601856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1649877507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 THOMAS MORE PKWY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173428",
            "telephone_number": "859-341-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 THOMAS MORE PKWY",
            "city": "CRESTVIEW HILLS",
            "state": "KY",
            "postal_code": "410173428",
            "telephone_number": "858-341-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRANDON",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-05",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "KY",
            "license": "TCA906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holli Renee Miller, M.ED., LPCC
• Justin R Miller, DO
• Jon Raymond Minzner, MD
• Nikki Mitchell-Ayres, PTA
• Donna M Montgomery, LCSW
• Rachel Marie Moreland
• Ana Elise Morgan, PT, DPT, PCS
• Neal J Moser, MD
• Kathy R Mount, MS, CCC
• Srilakshmi Mukalla, MD

• Athletic Trainer in Crestview Hills, KY
• Providers in Crestview Hills, KY by specialty
• Athletic Trainer in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.