Olivia Elizabeth Moore, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

348694-01 Issued in NY

Practice address

150 State St Ste 300
Rochester, NY 14614-1353

Phone

(585) 454-3550

NPI assigned

Nov 14, 2024

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maxim of New York, LLC

  • Home Health Agency
  • Rochester, NY
  • NPI 1265543706
  NPD

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

{
    "created_epoch": "1731542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1922822972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 VILLAGE II DRIVE",
            "address_2": "D",
            "city": "HILTON",
            "state": "NY",
            "postal_code": "14468",
            "telephone_number": "585-694-5564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 STATE ST STE 300",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146141353",
            "telephone_number": "585-454-3550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "OLIVIA",
        "middle_name": "ELIZABETH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-11-14",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NY",
            "license": "348694-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malcolm Moore
• Maura T Moore, MD
• Monekia Michelle Moore
• Monica Christine Moore, MD
• Nikko Moore, REGISTERED NURSE
• Paula Marie Moore, REGISTERED NURSE
• Richard Moore, MD
• Sara D Moore, LMSW
• Shannon Nicole Moore
• Tara Moore, PT, DPT

• Licensed Practical Nurse in Rochester, NY
• Providers in Rochester, NY by specialty
• Licensed Practical Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; 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.