Active NPI
Rodney Shane Moore
- Home Modifications Contractor
- Dryden, VA
National Provider Identifier
1831391408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Modifications Contractor
- License
- 2705 113696
- Practice address
- RR 1 Box 938
Dryden, VA 24243-9740 - Phone
- (276) 523-2884
- Fax
- (276) 523-4902
- NPI assigned
- Jun 4, 2007
- 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 |
|---|---|---|---|---|
| Home Modifications Contractor | 171WH0202X | 2705 113696 | VA | Primary |
Addresses
Primary practice location
RR 1 Box 938
Dryden, VA 24243-9740
Mailing address
RR 1 Box 938
Dryden, VA 24243-9740
Phone (276) 523-2884
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 |
|---|---|---|---|
| 2705 113696 | VA | MD | Home Modifications Contractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1180915200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1831391408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 938",
"city": "DRYDEN",
"state": "VA",
"postal_code": "242439740",
"telephone_number": "276-523-2884",
"fax_number": "276-523-4902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 1 BOX 938",
"city": "DRYDEN",
"state": "VA",
"postal_code": "242439740",
"telephone_number": "276-523-2884",
"fax_number": "276-523-4902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "RODNEY",
"middle_name": "SHANE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-06-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "171WH0202X",
"taxonomy_group": "",
"desc": "Contractor, Home Modifications",
"state": "VA",
"license": "2705 113696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dryden, VA
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.