Individual provider Active NPI

Felix Clifford Moore, LPN

  • Licensed Practical Nurse
  • Cincinnati, OH
National Provider Identifier
1861631913
Registry record updated Feb 12, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
129246 Issued in OH
Practice address
3657 Canyon Dr
Cincinnati, OH 45217-2101
Phone
(513) 751-6949
Fax
(513) 221-0098
NPI assigned
Feb 12, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 12, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 129246 OH Primary

Addresses

Primary practice location

3657 Canyon Dr
Cincinnati, OH 45217-2101

Mailing address

3657 Canyon Dr
Cincinnati, OH 45217-2101
Phone (513) 751-6949

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

LicenseStateTypeSpecialty
129246OHMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234396800000",
    "number": "1861631913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3657 CANYON DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452172101",
            "telephone_number": "513-751-6949",
            "fax_number": "513-221-0098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3657 CANYON DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452172101",
            "telephone_number": "513-751-6949",
            "fax_number": "513-221-0098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "FELIX",
        "middle_name": "CLIFFORD",
        "name_prefix": "Mr.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-02-12",
        "last_updated": "2009-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "129246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2009; 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.