Cory Ryan Moore

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

864 Issued in OK

Practice address

13501 N Bryant Ave
Edmond, OK 73013-6242

Phone

(405) 246-0222

NPI assigned

Feb 22, 2018

Last updated

Feb 22, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Practice roles

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

• Teal Creek Life Care Community Inc

  dba Teal Creek Assisted Living

  • Assisted Living Facility
  • Edmond, OK
  • NPI 1396279808
  NPD (past)

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519257600000",
    "number": "1952802167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12390 AUTUMN BRK",
            "city": "GUTHRIE",
            "state": "OK",
            "postal_code": "730447593",
            "telephone_number": "405-308-3426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 N BRYANT AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730136242",
            "telephone_number": "405-246-0222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CORY",
        "middle_name": "RYAN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-02-22",
        "last_updated": "2018-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "OK",
            "license": "864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beth Moon, LMFT-C
• Tabitha Moon
• Fabrice A. Mooney, LPC, LBP
• Casie Lea Moore, LPC
• Claire Lauren Moore, OD
• Deborah Jayne Moore, L.P.C.
• Deborah Jean Moore, LPC
• Ella Moore, PT, DPT
• Gabriele Elaine Moore, LPC
• Ida Moore, LPC

• Occupational Therapy Assistant in Edmond, OK
• Providers in Edmond, OK by specialty
• Occupational Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.