PHYLLIS S MOORE (NPI# 1467744979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467744979 |
| Entity Type | Individual |
| Full Name | PHYLLIS S MOORE |
| Credential | DNSCPMHCNSBC |
| Practice Address |
940 Belmont St Mclean Hospital Southeast Location Brockton MA 02301-5596 |
| Practice Telephone | 5088948300 |
| Mailing Telephone | 5088948300 |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2011-05-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364S00000X | Clinical Nurse Specialist | 79712 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134330483 | Phyllis C. Moore | Speech-Language Pathologist | 5111 Laird Ln, Jupiter, FL 33458-4095 | 2007-05-25 |
| 1497130017 | Phyllis Eugenia Moore | Nurse Practitioner | 100 Mallard Creek Rd, Suite 406, Louisville, KY 40207-4194 | 2015-07-24 |
| 1023374279 | Phyllis P Moore | Nurse Practitioner | 600 Main St, Friendship, TN 38034-1999 | 2012-04-02 |
| 1235407248 | Phyllis Ann Moore | Nurse Practitioner | 815 Pennsylvania Ave, Fort Worth, TX 76104-2224 | 2011-12-05 |
| 1164657706 | Phyllis Moore | Licensed Practical Nurse | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2009-05-27 |
| 1528125747 | Phyllis Jane Moore | Nurse Practitioner | 1200 El Camino Real, South San Francisco, CA 94080-3208 | 2007-01-03 |
| 1528136744 | Phyllis R Moore | Social Worker | 218 N Washington St, Phyllis R Moore Lcswr, Rome, NY 13440 | 2006-12-04 |
| 1407940604 | Phyllis Diane Moore I | Physical Therapy Assistant | 2710 Trotwood Ave, Columbia, TN 38401-4903 | 2006-10-03 |
| Street Address |
940 BELMONT ST MCLEAN HOSPITAL SOUTHEAST LOCATION |
| City | BROCKTON |
| State | MA |
| Zip Code | 02301-5596 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992779011 | Paul Moitoso | Social Worker | 940 Belmont St, 122 - Bldg 3, A-504a, Brockton, MA 02301-5596 | 2006-02-15 |
| 1255938262 | Matthew Janson | Recreation Therapist | 940 Belmont St, Brockton, MA 02301-5596 | 2020-10-02 |
| 1861099020 | Erin A Lawrence | Recreation Therapist | 940 Belmont St, Brockton, MA 02301-5596 | 2020-10-01 |
| 1720698442 | Ifeoma Laurietta Ugbo | Registered Nurse | 940 Belmont St, Brockton, MA 02301-5596 | 2020-08-06 |
| 1255959961 | Abigail Lauraine Munroe | Registered Nurse | 940 Belmont St, Brockton, MA 02301-5568 | 2020-07-09 |
| 1225653173 | Bryanna Morgan Caron | Optometrist | 940 Belmont St, Brockton, MA 02301-5596 | 2020-06-16 |
| 1134744675 | Marie Eva Dely | Registered Nurse | 940 Belmont St, Brockton, MA 02301-5596 | 2020-06-10 |
| 1255955142 | Daniel Salazar | Registered Nurse | 940 Belmont St, Brockton, MA 02301-5596 | 2020-06-05 |
| 1982227146 | Amelia Colby Rohan | Student in an Organized Health Care Education/Training Program | 940 Belmont St, Brockton, MA 02301-5596 | 2020-05-22 |
| 1952923526 | Amy Felicia Jones | Student in an Organized Health Care Education/Training Program | 940 Belmont St, Brockton, MA 02301-5596 | 2020-05-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942807110 | Jenny Vulpis | Recreation Therapist | 940 Belmont St (br 135), Brockton, MA 02301 | 2020-10-01 |
| 1205444924 | Caroline Storey | Counselor | Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 | 2020-07-20 |
| 1013546852 | Nuria Dos Santos Veiga | Occupational Therapist | 73 Denton St, Brockton, MA 02301 | 2020-04-03 |
| 1679113930 | Laura Ann Brondyk II | Counselor | 10 Christys Dr, Brockton, MA 02301 | 2020-01-14 |
| 1437796521 | Andrea Lopes | Developmental Therapist | 7 Goddard Road, Brockton, MA 02301 | 2019-12-08 |
| 1518420124 | Diligencehealthcare | Psychiatry & Neurology | 30-40 Westpark Street, Brockton, MA 02301 | 2019-04-10 |
| 1124530373 | Rachel Theys | Behavioral Analyst | 130 Liberty St Ste 13a, Brockton, MA 02301 | 2017-10-27 |
| 1689193369 | Anderson D Delgado | Behavior Technician | 11 Packard Way, Brockton, MA 02301 | 2017-09-14 |
| 1811415326 | Francesca Lavecchia | Clinical Neuropsychologist | Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 | 2017-09-05 |
| 1831615343 | Donna Marie Dugan | Counselor | South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 | 2017-08-16 |
| Find all providers in zip 02301 | ||||
| Taxonomy Code | 364S00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| A registered nurse who, through a graduate degree program in nursing, or through a formal post-basic education program or continuing education courses and clinical experience, is expert in a specialty area of nursing practice within one or more of the components of direct patient/client care, consultation, education, research and administration. |
| Notes: Sources: American Nurses Association, American Nurses Credentialing Center, 1996 Certification Catalogue and The Interagency Conference on Nursing Statistics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467483230 | Joan Stack Kovach | Clinical Nurse Specialist | Mclean Hospital Southeast Location, 940 Belmont Street, Brockton, MA 02301 | 2006-07-06 |
| 1194708032 | Maureen Dumas-lipka | Clinical Nurse Specialist | 110 Liberty St, Brockton, MA 00301-5521 | 2005-11-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487289641 | Carol P Corcoran | Clinical Nurse Specialist | 34 Lawrence St, Wakefield, MA 01880-1847 | 2020-03-09 |
| 1770618803 | Beverlee Sclar | Clinical Nurse Specialist | 8 Alton Place Suite #5, Brookline, MA 02446 | 2007-02-22 |
| 1629123542 | Jane M Woodman | Clinical Nurse Specialist | Appleton Building 2 No Main St Suite 3, Ipswich, MA 01938 | 2007-01-23 |
| 1467531426 | Peggy Louise Wolff | Clinical Nurse Specialist | 126 Cave Hill Road, Leverett, MA 01054-9728 | 2006-11-02 |
| 1043390909 | Ann Galligan | Clinical Nurse Specialist | 25 Mohawk Drive, Leominster, MA 01453 | 2006-10-16 |
| 1073609301 | Katherine A Blake | Clinical Nurse Specialist | 55 Pleasant Street, Newbury Port, MA 01950 | 2006-10-05 |
| 1770597429 | Elizabeth Mccusker-hunt | Clinical Nurse Specialist | 125 Liberty St Ste 2, Danvers, MA 01923-3325 | 2006-07-28 |
| 1881625242 | Rachel A Darian | Clinical Nurse Specialist | 169 Libbey Pkwy 2nd Floor, Weymouth, MA 02189-3101 | 2006-07-05 |
| 1891735726 | Rochelle Cooper | Clinical Nurse Specialist | 20 Watertown St, Watertown, MA 02472-2505 | 2006-06-08 |
| 1316984065 | Jeanette Marie Maddix | Clinical Nurse Specialist | 323 Boston Post Rd, Sudbury, MA 01776-3022 | 2006-06-01 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.