Johnny Oran Moore

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P0222296 Issued in NC

Practice address

351 Wagoner Dr Ste 411
Fayetteville, NC 28303-4608

Phone

(910) 994-2818

NPI assigned

Jun 24, 2025

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Rebirth-Heart and Mind PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1831915511

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1801783527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "842 E ORANGE ST",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283014676",
            "telephone_number": "919-638-0624",
            "fax_number": "919-638-0624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "351 WAGONER DR STE 411",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034608",
            "telephone_number": "910-994-2818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHNNY",
        "middle_name": "ORAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P0222296",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-30776",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carlitta Michelle Moore, MS, LAT, ATC
• Conne Schmidt Moore, LMT
• Devonia Moore, LMBT
• Hayden Gregory Moore, DO
• James Robert Moore, DPT
• Joshua Deion Moore
• Kaylee Gray Moore, PHARMD, MSCR
• Lisa Moore
• Maiah Yvonne Moore
• Mary Lisa Moore

• Clinical Social Worker in Fayetteville, NC
• Providers in Fayetteville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.