Reba Ann Moore, PSY.S.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

License

0008 Issued in KY

Practice address

85 W Point Dr
Corbin, KY 40701-8898

Phone

(606) 523-9723

NPI assigned

Apr 29, 2008

Last updated

Apr 29, 2008By 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

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.

• Green Meadows Wellness Center One, LLC

  • Clinical Psychologist
  • Corbin, KY
  • NPI 1902377864
  NPD (past)

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

{
    "created_epoch": "1209427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209427200000",
    "number": "1659546638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2865 BEE CREEK RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407017804",
            "telephone_number": "606-523-9723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 W POINT DR",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407018898",
            "telephone_number": "606-523-9723"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "REBA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "PSY.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-29",
        "last_updated": "2008-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "KY",
            "license": "0008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raymond J Monaco Jr., MD
• Julie Renee Monday, APRN
• Amanda Rose Monin
• Amy Lynn Moore, BS, LPCC
• Jason Moore, R.PH., PHARM.D.
• Robert Daniel Moore
• Slade Moore
• Thomas James Moore, MD
• Tiffany Renae Moore, BS, MHS
• Charlotte Marie Morgan, BS

• Intellectual & Developmental Disabilities Psychologist in Corbin, KY
• Providers in Corbin, KY by specialty
• Intellectual & Developmental Disabilities Psychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2008; 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.