Karin Moore

Primary specialty

OptometristTaxonomy code 152W00000X

License

2179 Issued in TN

Legal business name

KARIN MOORE

Practice address

114 Stuart Rd NE
#102
Cleveland, TN 37312-4803

Phone

(252) 985-1371

NPI assigned

Mar 20, 2007

Last updated

Jul 3, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Karin R Moore

Title

Optometrist

Phone

(252) 985-1371

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1669597514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7396",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 STUART RD NE",
            "address_2": "#102",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124803",
            "telephone_number": "252-985-1371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KARIN MOORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KARIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "252-985-1371"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00264124",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3943794",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "4121846",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Cleveland, TN
• Providers in Cleveland, TN by specialty
• Optometrist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.