LISA MOORE — NPI 1114357068 (Licensed & Credentialed Case Manager/Care Coordinator in BOLEY, OK)

CMS-1500 Box 24J / 33a • NPI

1114357068

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

171M00000X

Licensed & Credentialed Case Manager/Care Coordinator

Box 32 Service Location & ZIP+4

ROUTE 1 BOX 35D, BOLEY, OK, 74829

Official NPPES Practice Location

Practice Phone & Referral Fax

(918) 667-3367

Fax: (918) 667-3387

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1114357068 (LISA MOORE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1114357068` (NPI-1 Individual Practitioner)
Provider / Legal Name	LISA MOORE
Plain-English Specialty	Licensed & Credentialed Case Manager/Care Coordinator NUCC Code: `171M00000X` (Case Manager/Care Coordinator)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	ROUTE 1 BOX 35D, BOLEY, OK, 74829
Practice Telephone / Fax	Tel: (918) 667-3367 \| Fax: (918) 667-3387
Administrative Mailing Address	PO BOX 218, BOLEY, OK, 74829
Enumeration & Last Sync	Enumerated: 2013-11-13 \| CMS Record Updated: 2013-11-13

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

ROUTE 1 BOX 35D, BOLEY, OK, 74829

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Plain-English Taxonomy & CMS Crosswalk (171M00000X)

What Does Taxonomy Code 171M00000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 171M00000X translates to:
"Licensed & Credentialed Case Manager/Care Coordinator"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Case Manager/Care Coordinator for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (LISA MOORE)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`171M00000X` — Case Manager/Care Coordinator Plain English: Licensed & Credentialed Case Manager/Care Coordinator	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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LISA MOORE (NPI #1114357068)