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Tracey Renee Moore , LPN

Licensed Practical Nurse β€’ Cincinnati, OH

Active NPI 1730329962 Individual Practitioner Female Practitioner
Practice location in NPPES

830 Ezzard Charles Dr
Cincinnati, OH 452142525

Call 5133816672 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

830 Ezzard Charles Dr

Cincinnati, OH 452142525

Telephone 5133816672
Organization at the Same NPPES Address or Phone
Center For Addiction Treatment Facility NPI 1215994249

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

NPI first issued

2009

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Cincinnati and Ohio

923 active clinicians are listed under Licensed Practical Nurse with a practice address in Cincinnati, OH (12,649 in Ohio).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Cincinnati

0% of these 923 clinicians have the CMS telehealth indicator.

0% of these 923 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-09-17
Licensed Practical Nurse Primary Specialty

NUCC Taxonomy Code: 164W00000X

License # reported to NPPES OH LPN.129245.MEDS

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: State Medical Board of Ohio.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

2 listed
Aba Anthony

Nurse Practitioner - Psychiatric/Mental Health

NPI 1366064727
Ama Bonsu , APRN

Nurse Practitioner - Family

NPI 1194703124

Advanced Practice Registered Nurse

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

20 Historical Events
πŸ“
Updated Practice Location September 17, 2023

Registered at 830 EZZARD CHARLES DR, CINCINNATI, OH 452142525 (Tel: 5133816672)

πŸ“
Updated Business Mailing Address September 17, 2023

Registered at 830 EZZARD CHARLES DR, CINCINNATI, OH 452142525 (Tel: 5133816672)

πŸ“
Updated Practice Location April 07, 2022

Registered at 6527 COLERAIN AVE, CINCINNATI, OH 452395537 (Tel: 8335104357)

πŸ“
Updated Business Mailing Address April 07, 2022

Registered at 615 ELSINORE PL, CINCINNATI, OH 452021459 (Tel: 8335104357)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 07, 2022

Licensed Practical Nurse (license number reported to NPPES: OH LPN.129245.MEDS)

πŸ‘€
Provider Name / Credentials Updated June 19, 2020

Recorded as TRACEY MOORE, LPN

πŸ“
Updated Practice Location February 27, 2018

Registered at 830 EZZARD CHARLES DR, CINCINNATI, OH 45214 (Tel: 5135787770)

πŸ“
Updated Business Mailing Address February 27, 2018

Registered at 830 EZZARD CHARLES DR., CINCINNATI, OH 45214 (Tel: 5133074915)

πŸ‘€
Provider Name / Credentials Updated February 27, 2018

Recorded as TRACEY LYONS, LPN

βœ…
NPI Profile Active June 07, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Business Mailing Address June 07, 2017

Registered at 2812 QUEEN CITY AVENUE, CINCINNATI, OH 452382401 (Tel: 5133074915)

πŸ“
Updated Practice Location June 07, 2017

Registered at 6427 TYLERS CROSSING, WEST CHESTER, OH 450692401 (Tel: 5135787770)

πŸ‘€
Provider Name / Credentials Updated June 07, 2017

Recorded as TRACEY 2812 QUEEN CITY AVENUE, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) June 07, 2017

Licensed Practical Nurse (license number reported to NPPES: OH PN129245)

βœ…
NPI Profile Active January 04, 2011

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) January 04, 2011

Registered at 6427 TYLERS CROSSING, WEST CHESTER, OH 450692401 (Tel: 5135787770)

πŸ“
Business Mailing Address (Initial Record) January 04, 2011

Registered at 6427 TYLERS CROSSING, WEST CHESTER, OH 450692401 (Tel: 5135787770)

πŸ‘€
Provider Name / Credentials (Initial Record) January 04, 2011

Recorded as TRACEY MOORE, LPN

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) January 04, 2011

Licensed Practical Nurse (license number reported to NPPES: OH PN129245)

🟒
Initial NPI Registration & Enumeration February 27, 2009

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1730329962
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 27, 2009
Last Update: September 17, 2023
Sole Proprietor: Yes

Mailing Address

830 Ezzard Charles Dr

Cincinnati, OH 452142525

Phone: 5133816672

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.