Heather Moore, REGISTERED NURSE

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

4704357074 Issued in MI

Practice address

1200 N Telegraph Rd
Pontiac, MI 48341-1032

Phone

(248) 451-2600

NPI assigned

Sep 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1694649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1831977578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16570 ILENE ST # A",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212814",
            "telephone_number": "313-605-8082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 N TELEGRAPH RD",
            "city": "PONTIAC",
            "state": "MI",
            "postal_code": "483411032",
            "telephone_number": "248-451-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HEATHER",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-14",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704357074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Janel Montgomery
• Megan Montgomery
• Jane Elizabeth Moody, RPH
• Dominique Moore
• Erin Moore, MA, LLPC
• Teresa Burow Moore, LPC
• Angela Mora
• Andrea Moreno
• Michelle Stacy Moreno
• Jon B Morris, PAC

• Psychiatric/Mental Health Registered Nurse in Pontiac, MI
• Providers in Pontiac, MI by specialty
• Psychiatric/Mental Health Registered Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.