Lavonda Moore

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

License

005486967 Issued in LA

Practice address

7607 Fern Ave Ste 404405
Shreveport, LA 71105-5739

Phone

(318) 284-8481

NPI assigned

Nov 26, 2018

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 names 1

• Lavonda Moore Professional name

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": "1543190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543190400000",
    "number": "1881163509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 404405",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055739",
            "telephone_number": "318-284-8481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7607 FERN AVE STE 404405",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711055739",
            "telephone_number": "318-284-8481"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAVONDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-11-26",
        "last_updated": "2018-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": "LA",
            "license": "005486967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LAVONDA",
            "last_name": "MOORE",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jonifer Shurae Moore
• Julia Moore
• Justin Moore, PHYSICIAN ASSISTANT
• Lashonda Moore
• Latronia Moore
• Leon Moore
• Lindsey Moore, APN
• Loni Moore, MS
• Lonnie Moore Jr.
• Mara Beth Moore, LOTR

• Behavior Technician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Behavior Technician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2018; 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.