Lakesha Marion Moore

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2886-19 Issued in WI

Practice address

6735 W Bradley Rd
Milwaukee, WI 53223-3325

Phone

(414) 362-0847

Fax

(414) 371-2390

NPI assigned

Apr 10, 2019

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

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": "1554854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1912460403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S36W30435 SAINT DAVIDS DR",
            "city": "WAUKESHA",
            "state": "WI",
            "postal_code": "531899287",
            "telephone_number": "262-470-7105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6735 W BRADLEY RD",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532233325",
            "telephone_number": "414-362-0847",
            "fax_number": "414-371-2390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAKESHA",
        "middle_name": "MARION",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-10",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WI",
            "license": "2886-19",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karmelita Moore
• Katherine D Moore, AU.D. CCC-A
• Kaylen Marua Moore, RN
• Keisha Moore
• Keyiana Moore
• Lawrence M Moore, MD
• Lundria S Moore, LPN
• Maren Brooke Moore
• Maria A Moore, ICS
• Monifa Moore

• Physical Therapy Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physical Therapy Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; 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.