Active NPI
Drew Moore, ATC
- Prevention Professional
- Wilmington, NC
National Provider Identifier
1821535659
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prevention Professional
- License
- LAT-2582
- Practice address
- 321 Bors Run
101
Wilmington, NC 28403-2687 - Phone
- (914) 275-5985
- NPI assigned
- Jan 31, 2017
- Last updated
- Jan 31, 2017
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prevention Professional | 405300000X | LAT-2582 | NC | Primary |
Addresses
Primary practice location
321 Bors Run
101
Wilmington, NC 28403-2687
Mailing address
321 Bors Run
101
Wilmington, NC 28403-2687
Phone (914) 275-5985
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LAT-2582 | NC | MD | Prevention Professional |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1485820800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485820800000",
"number": "1821535659",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "321 BORS RUN",
"address_2": "101",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284032687",
"telephone_number": "914-275-5985"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "321 BORS RUN",
"address_2": "101",
"city": "WILMINGTON",
"state": "NC",
"postal_code": "284032687",
"telephone_number": "914-275-5985"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DREW",
"credential": "ATC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-01-31",
"last_updated": "2017-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "405300000X",
"taxonomy_group": "",
"desc": "Prevention Professional",
"state": "NC",
"license": "LAT-2582",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.