Patricia Moore

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

665 Seward Ave NW
Grand Rapids, MI 49504-5190

Phone

(616) 265-0105

NPI assigned

Feb 28, 2024

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739836800000",
    "number": "1972369767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 SEWARD AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 SEWARD AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495045190",
            "telephone_number": "616-265-0105"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2036 Jerome Ave SW",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495072327",
            "country_code": "US",
            "telephone_number": "616-443-4219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PATRICIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lois Anne Moore, MSW, LMSW, LMFT
• Lyanna Renay Moore, DOULA, CLS
• Madison Renae Moore
• Mikayla C Moore
• Nydra Moore, LCSW
• Reece Moore, MD
• Sara Jane Moore, AGACNP
• Shawn David Moore, MD
• Sidney Moore
• Spencer Edmund Moore

• Community Health Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Community Health Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; 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.