Pickens Moore

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I-3118 Issued in NM

Legal business name

PICKENS MOORE

Practice address

100 E Aztec Ave
Gallup, NM 87301-6256

Phone

(505) 863-7472

Fax

(505) 863-7472

NPI assigned

Apr 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Pickens Moore

Title

Lisw

Phone

(505) 863-7472

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1460678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460678400000",
    "number": "1770937732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3306 CHURCH ROCK ST",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873014506",
            "telephone_number": "505-863-7472",
            "fax_number": "505-863-7472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E AZTEC AVE",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873016256",
            "telephone_number": "505-863-7472",
            "fax_number": "505-863-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICKENS MOORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-15",
        "last_updated": "2016-04-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PICKENS",
        "authorized_official_title_or_position": "LISW",
        "authorized_official_telephone_number": "505-863-7472",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NM",
            "license": "I-3118",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "L9282",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cara L. Phillips, RN
• Catherine J Phillips, RN
• Curtis Phillips
• Kristen Marie Phoenix, RN
• Allison K Pianka, RN
• Brian Pierce
• Stephen Lewis Pierce, MD
• Georgianna Piestewa, R.N.
• Kristen Joy Pikaart, CHW
• Timothy J Pikaart

• Social Worker in Gallup, NM
• Providers in Gallup, NM by specialty
• Social Worker in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.

Verify at the official NPI Registry.