Individual provider Active NPI

Sharon Moore, OT

  • Occupational Therapist
  • Richmond, IN
National Provider Identifier
1760575955
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
31001561A Issued in IN
Practice address
1400 Highland Rd
Suite 4
Richmond, IN 47374-9239
Phone
(765) 939-0820
Fax
(765) 939-0920
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 31001561A IN Primary

Addresses

Primary practice location

1400 Highland Rd
Suite 4
Richmond, IN 47374-9239

Mailing address

1400 Highland Rd
Suite 4
Richmond, IN 47374-9239
Phone (765) 939-0820

Other identifiers 1

IdentifierTypeStateIssuer
000000220923OtherINANTHEM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121009000825 IN Practitioner - Occupational Therapist in Private Practice 3173772050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

750 Chester Blvd
Richmond, IN 47374-1900
Phone (765) 939-0820

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Whitewater Valley Health Care Management and Marketing Inc CurrentSince Aug 1, 2012 Accepting new patients

Locations

1400 Highland Rd
Ste 4
Richmond, IN 47374
Phone (765) 939-0820

750 Chester Blvd
Richmond, IN 47374
Phone (765) 939-0820

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760575955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HIGHLAND RD",
            "address_2": "SUITE 4",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473749239",
            "telephone_number": "765-939-0820",
            "fax_number": "765-939-0920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HIGHLAND RD",
            "address_2": "SUITE 4",
            "city": "RICHMOND",
            "state": "IN",
            "postal_code": "473749239",
            "telephone_number": "765-939-0820",
            "fax_number": "765-939-0920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHARON",
        "credential": "OT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "IN",
            "license": "31001561A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000220923",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.