Active NPI
Rosa Gutierrez Moore, CCC-A
- Audiologist
- El Paso, TX
National Provider Identifier
1871797274
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 80068
- Practice address
- 201 Blacker Ave
El Paso, TX 79902-3324 - Phone
- (915) 532-4327
- Fax
- (915) 532-4328
- NPI assigned
- Jun 12, 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 |
|---|---|---|---|---|
| Audiologist | 231H00000X | 80068 | TX | Primary |
Addresses
Primary practice location
201 Blacker Ave
El Paso, TX 79902-3324
Mailing address
5852 Lawndale Dr
El Paso, TX 79912-4225
Phone (915) 833-5483
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 |
|---|---|---|---|
| 80068 | TX | MD | Audiologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871797274",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5852 LAWNDALE DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799124225",
"telephone_number": "915-833-5483"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 BLACKER AVE",
"city": "EL PASO",
"state": "TX",
"postal_code": "799023324",
"telephone_number": "915-532-4327",
"fax_number": "915-532-4328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ROSA",
"middle_name": "GUTIERREZ",
"name_prefix": "Mrs.",
"credential": "CCC-A",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-06-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "80068",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
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.