Active NPI
Larry Dwayne Moyer, LPN
- Licensed Practical Nurse
- Hamilton, OH
National Provider Identifier
1700915469
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN082169
- Practice address
- 3280 Black Oak Dr
Hamilton, OH 45011-9505 - Phone
- (513) 804-7419
- NPI assigned
- Mar 5, 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 |
|---|---|---|---|---|
| Religious Nonmedical Nursing Personnel | 374T00000X | PN082169 | OH | |
| Licensed Practical Nurse | 164W00000X | PN082169 | OH | Primary |
Addresses
Primary practice location
3280 Black Oak Dr
Hamilton, OH 45011-9505
Mailing address
3280 Black Oak Dr
Hamilton, OH 45011-9505
Phone (513) 804-7419
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 |
|---|---|---|---|
| PN082169 | OH | MD | Religious Nonmedical Nursing Personnel |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1700915469",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3280 BLACK OAK DR",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450119505",
"telephone_number": "513-804-7419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3280 BLACK OAK DR",
"city": "HAMILTON",
"state": "OH",
"postal_code": "450119505",
"telephone_number": "513-804-7419"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOYER",
"first_name": "LARRY",
"middle_name": "DWAYNE",
"credential": "LPN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "374T00000X",
"taxonomy_group": "",
"desc": "Religious Nonmedical Nursing Personnel",
"state": "OH",
"license": "PN082169",
"primary": false
},
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN082169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hamilton, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.