Sheronda Chantell Moore, MSOT, OTR/L

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

88001256A Issued in IN

Practice address

7136 Gettysburg Pike
Fort Wayne, IN 46804-5680

Phone

(260) 745-3322

NPI assigned

Dec 17, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Crosswinds Inc

  • Counselor
  • Fort Wayne, IN
  • NPI 1497170427
  Medicare reassignment NPD

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

{
    "created_epoch": "1450310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1730544842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8040 UPLAND CT",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462789585",
            "telephone_number": "803-837-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7136 GETTYSBURG PIKE",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045680",
            "telephone_number": "260-745-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHERONDA",
        "middle_name": "CHANTELL",
        "credential": "MSOT, OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-17",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "9065",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "SC",
            "license": "3992",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "88001256A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Elyse Moore, MT-BC
• Katie Rae Moore, LPN
• Kelsea Moore
• Nancy L Moore
• Sarah Michelle Moore, APRN-CNM, PMHNP-BC
• Starr R Moore
• Toya Moore
• Vincent Paul Moore, MD, MPH
• Virginia M Moore, LMHC, LSW, MS ED,
• Christine Jenifer Mora, NP

• Mental Health Counselor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Mental Health Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.