Active NPI
Linda Moore, RD
- Registered Dietitian
- Tifton, GA
National Provider Identifier
1871665919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- LD001273
- Practice address
- 901 18TH St E
Tifton, GA 31794-3648 - Phone
- (229) 353-6208
- Fax
- (229) 353-7722
- NPI assigned
- Nov 14, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD001273 | GA | Primary |
Addresses
Primary practice location
901 18TH St E
Tifton, GA 31794-3648
Mailing address
901 18TH St E
Tifton, GA 31794-3648
Phone (229) 353-6208
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LD001273 | Other | GA | STATE LICENSE NUMBER |
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 |
|---|---|---|---|
| LD001273 | GA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871665919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "901 18TH ST E",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943648",
"telephone_number": "229-353-6208",
"fax_number": "229-353-7722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 18TH ST E",
"city": "TIFTON",
"state": "GA",
"postal_code": "317943648",
"telephone_number": "229-353-6208",
"fax_number": "229-353-7722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "LINDA",
"credential": "RD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "GA",
"license": "LD001273",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "LD001273",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tifton, GA
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.