NPIMap

Organization Active NPI

Experiencing Moore, PC

  • Marriage & Family Therapist
  • Owatonna, MN
National Provider Identifier
1740666122
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1675 Issued in MN
Legal business name
EXPERIENCING MOORE, PC
Practice address
1414 South Oak Ave
Suite 6
Owatonna, MN 55060-3957
Phone
(507) 676-6834
Fax
(507) 413-8088
NPI assigned
Aug 7, 2015
Last updated
Sep 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Authorized official

Name
Ms. Margaret P Moore, LMFTNPI 1184787632
Title
President
Phone
(507) 676-6834

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1675 MN Primary

Addresses

Primary practice location

1414 South Oak Ave
Suite 6
Owatonna, MN 55060-3957

Mailing address

1414 South Oak Ave
Suite 6
Owatonna, MN 55060-3957
Phone (507) 676-6834

Other identifiers 1

IdentifierTypeStateIssuer
4628710MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211208002841 MN Part B Supplier - Clinic/Group Practice 2466842364 Receives reassigned benefits from 4 practitioners
Practice locations: Owatonna, MN

National Provider Directory

National Provider Directory

Locations

1414 S Oak Ave
Ste 6
Owatonna, MN 55060
Phone (507) 363-9063

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1740666122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1414 SOUTH OAK AVE",
            "address_2": "SUITE 6",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603957",
            "telephone_number": "507-676-6834",
            "fax_number": "507-413-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1414 SOUTH OAK AVE",
            "address_2": "SUITE 6",
            "city": "OWATONNA",
            "state": "MN",
            "postal_code": "550603957",
            "telephone_number": "507-676-6834",
            "fax_number": "507-413-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXPERIENCING MOORE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MARGARET",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "507-676-6834",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4628710",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owatonna, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.