Lavonne M Moore, RNC CNM

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

R1138272 Issued in MN

Practice address

1313 Penn Avenue North
Minneapolis, MN 55441

Phone

(612) 543-2500

Fax

(612) 302-4870

NPI assigned

Apr 27, 2006

Last updated

Feb 26, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Hennepin CountyGroup PAC ID 7911892849, 132 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hennepin County Medical Center Hospital, Minneapolis, MN, CCN 240004

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Midwife, Certified Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Hennepin County

  dba Hennepin County Mental Health Center

  • Psychiatry Physician
  • Minneapolis, MN
  • NPI 1780790345
  Medicare reassignment Care Compare group NPD
• Hennepin County

  dba NorthPoint Health & Wellness Center- Main Clinic

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1215951751
  NPD
• Hennepin County

  dba Endeavors

  • Federally Qualified Health Center (FQHC)
  • Minneapolis, MN
  • NPI 1962147413
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hennepin Healthcare System, Inc

  dba Hennepin County Medical Center

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1407897309
  Care Compare affiliation

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361836800000",
    "number": "1750348546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 PENN AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "612-543-2500",
            "fax_number": "612-302-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 PENN AVENUE NORTH",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55441",
            "telephone_number": "612-543-2500",
            "fax_number": "612-302-4870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAVONNE",
        "middle_name": "M",
        "credential": "RNC CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2013-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R1138272",
            "primary": true
        },
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MN",
            "license": "R113827-2",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "702615300",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Johanna Catherine Moore, M.D.
• John Patrick Moore, LICSW
• Jordan Leigh Moore
• Julie Glendenning Moore, PT
• Kristin Marie Glumack Moore
• Lisa Lynelle Moore, MSW, LICSW, PHD
• Mackenzie M Moore
• Michael Condi CT Moore, MD
• Rachel Aili Moore, D.C.
• Rebecca Moore, LICSW

• Nurse Practitioner in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2013; 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.