Marissa Ann Moore, B.S.

Primary specialty

NutritionistTaxonomy code 133N00000X

Practice address

75 De Smet Dr
Florissant, MO 63031-8404

Phone

(314) 348-1629

NPI assigned

Jan 5, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1861153405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 DE SMET DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318404",
            "telephone_number": "314-348-1629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 DE SMET DR",
            "city": "FLORISSANT",
            "state": "MO",
            "postal_code": "630318404",
            "telephone_number": "314-348-1629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARISSA",
        "middle_name": "ANN",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1234567590",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "marissa.moore.pnc@gmail.com",
            "affiliation": "N",
            "endpointDescription": "Internship",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Internship",
            "address_1": "75 De Smet Dr",
            "city": "Florissant",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630318404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kareemah Ayesha Moment
• Catina Mondaine, LPTA, LNHA
• Jessica Marie Monroe, D.D.S
• Marnay Marion Moody
• Betty Moore, RN, BSN
• Nashea Moore
• Moores Home Health Care Inc
• Rachel Anne Morel, D.O.
• Morgan Home Care LLC
• Andrea Denise Morgan

• Nutritionist in Florissant, MO
• Providers in Florissant, MO by specialty
• Nutritionist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.