Active NPI
Jeffrey A Moore, OT
- Occupational Therapist
- Las Vegas, NV
National Provider Identifier
1942637269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 130359
- Practice address
- 7455 W Washington Ave
Suite 100
Las Vegas, NV 89128-4337 - Phone
- (702) 735-1875
- NPI assigned
- Oct 1, 2013
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 130359 | NV | Primary |
Addresses
Primary practice location
7455 W Washington Ave
Suite 100
Las Vegas, NV 89128-4337
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130359 | NV | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1437523200000",
"number": "1942637269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "630-296-2223",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7455 W WASHINGTON AVE",
"address_2": "SUITE 100",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891284337",
"telephone_number": "702-735-1875"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JEFFREY",
"middle_name": "A",
"credential": "OT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-10-01",
"last_updated": "2015-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NV",
"license": "130359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.