KENNETH EARL MOORE (NPI# 1669409967) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669409967 |
| Entity Type | Individual |
| Full Name | KENNETH EARL MOORE |
| Credential | ATC |
| Practice Address |
901 Lincoln Rd Idabel OK 74745-7802 |
| Mailing Address |
300 High St Idabel OK 74745-4023 |
| Practice Telephone | 5802129785 |
| Mailing Telephone | 5802082804 |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT-66 | OK | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134490766 | Kenneth Moore | Skilled Nursing Facility | 751 Orange Ave, Saint Cloud, FL 34769-3063 | 2012-01-12 |
| 1376722348 | Kenneth Jerald Moore | Social Worker | 6906 S Utica Pl, Tulsa, OK 74136-5158 | 2007-10-26 |
| 1891899258 | Kenneth Lawrence Moore | Psychiatry & Neurology | 12 Tartan Ridge Rd, Burr Ridge, IL 60527-8904 | 2006-09-07 |
| 1326096470 | Kenneth Edward Moore | Physical Medicine & Rehabilitation | Mcguire Vamc, 1201 Broad Rock Rd, Richmond, VA 23249 | 2006-05-04 |
| 1013995323 | Kenneth Levi Moore IIi | Nurse Practitioner | 5981 Far Hills Ave, Dayton, OH 45429-2211 | 2006-01-06 |
| 1245889021 | Kenneth Moore | Dentist | 611 S George Nigh Expy, Mcalester, OK 74501-7277 | 2019-09-05 |
| 1144796103 | Kenneth Moore | Behavior Technician | 41521 W 11 Mile Rd, Novi, MI 48375-1803 | 2018-10-17 |
| 1568963627 | Kenneth Sheppard Moore | Military Health Care Provider | 34800 Bob Wilson Dr, San Diego, CA 92134-1098 | 2018-02-23 |
| 1710358445 | Kenneth Steven Moore | Psychologist | 100 Ledgehill Rd, Bennington, VT 05201-2273 | 2015-10-07 |
| 1013304054 | Kenneth Adam Moore | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Suite 1031, Memphis, TN 38103-3403 | 2015-04-16 |
| Street Address |
901 LINCOLN RD |
| City | IDABEL |
| State | OK |
| Zip Code | 74745-7802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568957348 | Home Run Healthcare | Family Medicine | 1425 East Lincoln Road, Suite A-3, Idabel, OK 74745 | 2018-06-25 |
| 1720457203 | Leann Tomlinson | Registered Nurse | 2002 E Lincoln Rd, Idabel, OK 74745 | 2015-09-15 |
| 1659795508 | Laura Rush | Optometrist | 902 Lincoln Road, Idabel, OK 74745 | 2014-02-13 |
| 1619301116 | White River Home Health | Home Health | 2100 East Washington Street Ste D, Idabel, OK 74745 | 2013-09-03 |
| 1922440999 | John Phillip Stone Scoggin | Counselor | 111 Canterbury Lane, Idabel, OK 74745 | 2013-07-19 |
| 1841576725 | Ayesha Shante Wyatt | Nurse's Aide | 1800 Hillcrest, Idabel, OK 74745 | 2011-10-24 |
| 1154569457 | Southern Oklahoma Treatment Services, Inc. | Community/Behavioral Health | 6 Southeast Avenue A, Idabel, OK 74745 | 2009-01-26 |
| 1417103854 | John Hoskins | Internal Medicine | 902 Lincoln Rd, Choctaw Nation Health Clinic, Idabel, OK 74745 | 2008-08-18 |
| 1801077045 | Rhonda Cheryl Rodgers | Counselor | 104 Ne Ave A, Idabel, OK 74745 | 2007-11-15 |
| 1326241548 | Beverly Gayle Jasper-hayes | Counselor | 104 Ne A - Avenue, Idabel, OK 74745 | 2007-06-06 |
| Find all providers in zip 74745 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083227110 | Mercedes Phegley | Specialist/Technologist | 2815 E 5th St Apt 1936, Tulsa, OK 74104-3122 | 2020-08-28 |
| 1437761657 | Sierra Harmon | Specialist/Technologist | 214 S Water St, Sapulpa, OK 74066-4236 | 2020-08-19 |
| 1689285363 | Meredith Galloway | Specialist/Technologist | 2806 E 8th St Apt 3022, Tulsa, OK 74104-7402 | 2020-08-14 |
| 1821616038 | Aaron Michael Gowens | Specialist/Technologist | 015 Wantland Hall 100 University Dr., Edmond, OK 73034 | 2020-07-14 |
| 1427681766 | Brianna Lee Brooks | Specialist/Technologist | 3014 E 8th St Apt 4313, Tulsa, OK 74104-7436 | 2020-02-14 |
| 1467084806 | Jessica Lyn Johnson | Specialist/Technologist | 23 E 157th Pl S, Glenpool, OK 74033-4437 | 2020-02-04 |
| 1083245948 | Hana Young Clancy | Specialist/Technologist | 2626 S Trenton Ave, Tulsa, OK 74114-2728 | 2020-01-30 |
| 1033740121 | Taylor Deeanne Pitcock | Specialist/Technologist | 180 W Brooks St Norman Ok 1335-1, Norman, OK 73019-0001 | 2020-01-28 |
| 1164052148 | Marlow Rehab Services, Pllc | Specialist/Technologist | 304 W. Gilkey, Marlow, OK 73055-1224 | 2020-01-18 |
| 1023658424 | Amber Martin | Specialist/Technologist | 9201 N 22nd West Pl, Sperry, OK 74073-4141 | 2020-01-14 |
| Find all providers with the same taxonomy | ||||
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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.