KIMBERLY AUNDREA MOORE (NPI# 1528689205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528689205 |
| Entity Type | Individual |
| Full Name | KIMBERLY AUNDREA MOORE |
| Practice Address |
279 Summit Dr Waterford MI 48328-3364 |
| Practice Telephone | 2487454900 |
| Mailing Telephone | 2487454900 |
| Enumeration Date | 2020-05-04 |
| Last Update Date | 2020-05-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 175T00000X | Peer Specialist | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518661 | Kimberly Sue Moore | Nurse Practitioner | 1196 Sardis Rd, Mount Olivet, KY 41064-7580 | 2020-11-02 |
| 1528668878 | Kimberly Dawn Moore | Technician | 1211 Chapps Fork Rd, Charleston, WV 25312-7702 | 2020-10-27 |
| 1487117966 | Kimberly Dawn Moore | Counselor | 6315 Aylesworth Ave, Lincoln, NE 68505-1276 | 2019-04-10 |
| 1679051981 | Kimberly Ann Moore | Social Worker | 1 Richmond Sq Ste 333, Providence, RI 02906-5139 | 2018-07-31 |
| 1003352501 | Kimberly Ann Moore | Pharmacist | 174 Dapplegray Rd, Bell Canyon, CA 91307-1011 | 2017-01-09 |
| 1336596790 | Kimberly Moore | Counselor | 117 W 130th St, New York, NY 10027-2007 | 2016-05-16 |
| 1013300953 | Kimberly Moore | Occupational Therapist | 217 Bainbridge Cir, Muscle Shoals, AL 35661-4320 | 2015-03-17 |
| 1710390521 | Kimberly Moore | Speech-Language Pathologist | 660 Barnett Shoals Rd Apt 211, Athens, GA 30605-7613 | 2014-06-09 |
| 1841568706 | Kimberly Ann Moore | Physical Therapy Assistant | 1109 W 21st St, Lawrence, KS 66046-2831 | 2011-12-07 |
| 1710265368 | Kimberly Dawn Moore | Nurse Practitioner | 814 South 3rd Street, Minneapolis, MN 55415 | 2011-08-01 |
| Street Address |
279 SUMMIT DR |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053364307 | Mark Anthony Mitchell | Social Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2006-05-18 |
| 1699376533 | Kiersten Gutherman | Social Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-11-06 |
| 1316551427 | Doris Vernita Jenkins | Social Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-09-04 |
| 1477182491 | Holly Richard | Registered Nurse | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-04-02 |
| 1437784014 | Diana L Tige | Community Health Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-03-04 |
| 1063046928 | Amy Stern | Social Worker | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-28 |
| 1225661382 | Keith Albert Robinson | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-18 |
| 1326671660 | Kathy Sue Barber | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-14 |
| 1023641388 | Deundra Denise Fuller | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-14 |
| 1336772862 | Joshua Andrew Blanden | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| Taxonomy Code | 175T00000X |
| Grouping | Other Service Providers |
| Classification | Peer Specialist |
| Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. |
| Notes: Source: National Uniform Claim Committee [7/1/2014: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396127510 | Timothy Tout II | Peer Specialist | 4150 Elmhurst Rd, Waterford, MI 48328-4029 | 2015-06-24 |
| 1225661382 | Keith Albert Robinson | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-18 |
| 1326671660 | Kathy Sue Barber | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-14 |
| 1023641388 | Deundra Denise Fuller | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-14 |
| 1336772862 | Joshua Andrew Blanden | Peer Specialist | 279 Summit Dr, Waterford, MI 48328-3364 | 2020-02-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026284 | Leah Mae Sindone | Peer Specialist | 22324 Derby Rd, Woodhaven, MI 48183-3700 | 2020-09-04 |
| 1992314728 | Willie Earl Feggins | Peer Specialist | 370 Country Club Rd, Holland, MI 49423-8303 | 2020-07-28 |
| 1831711613 | John Lee Williams Jr. | Peer Specialist | 24400 Schoolcraft, Redford, MI 48239-2633 | 2020-05-14 |
| 1568084861 | Zannie Roy Jackson Jr. | Peer Specialist | 36801 Ann Arbor Trl, Livonia, MI 48150-3422 | 2020-05-11 |
| 1417578865 | Veronica R Vasquez | Peer Specialist | 500 Hancock St # 48602, Saginaw, MI 48602-4224 | 2020-04-27 |
| 1235768680 | Matthew Milz | Peer Specialist | 145o S Lapeer Rd, Oxford, MI 48371-4982 | 2020-04-07 |
| 1558996132 | Camille Jewell Jackson | Peer Specialist | 8181 N Wayne Rd Apt S2147, Westland, MI 48185-3842 | 2020-03-04 |
| 1073146908 | James Laroach | Peer Specialist | 913 W. Homes Suite 200, Lansing, MI 48910 | 2020-02-19 |
| 1578193827 | Axel Lee Gruenberg | Peer Specialist | 221790 West 9 Mile, Southfield, MI 48033 | 2020-01-24 |
| 1962032078 | Brianne Salchert | Peer Specialist | 1170 Michigan Rd., Port Huron, MI 48060 | 2020-01-17 |
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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.