MR. BRYAN J MOORE (NPI# 1124430871) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124430871 |
| Entity Type | Individual |
| Full Name | MR. BRYAN J MOORE |
| Practice Address |
80 State Highway 310 Suite 1 Canton NY 13617 |
| Practice Telephone | 3153862189 |
| Practice Fax Number | 3153862435 |
| Mailing Telephone | 3153862189 |
| Mailing Fax Number | 3153862435 |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811544869 | Bryan L Moore | Behavior Technician | 9247 Plume Grass St, Corona, CA 92883-8166 | 2019-08-23 |
| 1013408830 | Bryan Moore | Student in an Organized Health Care Education/Training Program | 5508 Arch Bridge Ct, Arlington, TX 76017-3524 | 2018-05-29 |
| 1104141662 | Bryan J Moore | Psychiatry & Neurology | Intouch Health / C3o Telemedicine, 7402 Hollister Avenue, Santa Barbara, CA 93117 | 2010-03-28 |
| 1598828709 | Bryan Eugene Moore | Chiropractor | 412 Ponce De Leon Dr, Ste B, Hot Springs Village, AR 71909-8121 | 2006-12-18 |
| 1912351396 | Bryan Moore | Case Manager/Care Coordinator | 1517 W Garvey Ave N, West Covina, CA 91790-2138 | 2016-04-21 |
| 1528398989 | Bryan Anderson Moore | Physical Therapist | 1815 Roselawn Ave, Monroe, LA 71201-5433 | 2010-01-07 |
| 1982805040 | Bryan Moore | Dentist | 7777 Forest Ln, Suite C-104, Dallas, TX 75230-2505 | 2007-05-29 |
| 1356388433 | Bryan Russell Moore | Physician Assistant | 501 Redmond Rd Nw, Anesthesiology Department, Rome, GA 30165-1415 | 2006-05-31 |
| Street Address |
80 STATE HIGHWAY 310 SUITE 1 |
| City | CANTON |
| State | NY |
| Zip Code | 13617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730277138 | Sarah Kate Murphy | Counselor | 80 State Highway 310, Canton, NY 13617-1436 | 2006-10-11 |
| 1881236131 | Crystal Ralston | Counselor | 80 State Highway 310, Canton, NY 13617-1436 | 2019-10-08 |
| 1063063683 | Ronee K Cree | Peer Specialist | 80 State Highway 310, Canton, NY 13617-1436 | 2019-09-25 |
| 1730733221 | Alexandria Horner | Registered Nurse | 80 State Highway 310, Canton, NY 13617-1436 | 2019-08-01 |
| 1902369242 | Michele Lee Earle | Registered Nurse | 80 State Highway 310, Canton, NY 13617-1436 | 2019-04-12 |
| 1992278048 | Joann Pfeil | Case Manager/Care Coordinator | 80 State Highway 310, Canton, NY 13617-1436 | 2019-01-10 |
| 1659844827 | Karen S Sabourin | Registered Nurse | 80 State Highway 310, Suite 1, Canton, NY 13617 | 2019-01-09 |
| 1326516683 | Shannon Ashley | Registered Nurse | 80 State Highway 310, Canton, NY 13617-1436 | 2018-11-05 |
| 1801377940 | Kelli Gary | Counselor | 80 State Highway 310, Canton, NY 13617-1436 | 2018-08-27 |
| 1013447275 | Dawn M Colbert | Social Worker | 80 State Highway 310, Canton, NY 13617-1436 | 2017-06-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700428802 | Meagan Elizabeth Hogan | Physician Assistant | 6119 Us Highway Route 11, Canton, NY 13617 | 2019-10-10 |
| 1982251740 | Wilma J. Blackmer | Technician | 1756 Cr 14, Canton, NY 13617 | 2019-08-26 |
| 1326525270 | Kylie Broughal | Physician Assistant | 6119 St Hwy Rt 11, St Lawrence Medical Office Complex, Canton, NY 13617 | 2018-07-24 |
| 1891299608 | Sheena Teresa Smith | Counselor | 310 State Highway 310, Suite 1, Canton, NY 13617 | 2018-03-19 |
| 1972024594 | Patrick James Sullivan | Physician Assistant | 6619 State Highway Route 11, Canton, NY 13617 | 2017-07-05 |
| 1225482763 | Howard Orthotics and Prosthetics, LLC | Prosthetic/Orthotic Supplier | 6128 Us Highway11, Canton, NY 13617 | 2016-04-21 |
| 1831534452 | Chin Hung Ho | Dermatology | 6119 State Highway Rt 11, Cph Dermotology, Canton, NY 13617 | 2013-05-09 |
| 1194061663 | Sarah Prairie | Counselor | 80 State Hwy 310, Suite 1, Canton, NY 13617 | 2013-01-02 |
| 1679859094 | Nathan Ellis | Occupational Therapist | 139 Outer State St. Rd, Canton, NY 13617 | 2011-10-31 |
| 1407139017 | Julianne Rutley | Occupational Therapist | 139 Outer State Street Rd, Canton, NY 13617 | 2011-09-21 |
| Find all providers in zip 13617 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851904890 | Aurora Health Services LLC | Counselor | 200 6th Street Nw, Canton, OH 44702-1005 | 2020-08-28 |
| 1942819032 | Restoration Community Services LLC | Counselor | 831 Market Ave N, Canton, OH 44702-1175 | 2020-07-24 |
| 1619590882 | A.v.o Behavioral Health LLC | Counselor | 3745 Whipple Ave Nw Ste A, Canton, OH 44718-4805 | 2020-05-22 |
| 1356976930 | Nadine Blase Psareas | Counselor | 1558 Marietta Hwy Ste 200, Canton, GA 30114-3615 | 2020-03-04 |
| 1245870591 | Adriane Everett | Counselor | 906 12 St Nw, Canton, OH 44703 | 2020-01-14 |
| 1770123812 | Kelly Wells | Counselor | 906 12th St Nw, Canton, OH 44703-1902 | 2020-01-07 |
| 1528601663 | Shelly R Bowling | Counselor | 1522 Baum St Se, Canton, OH 44707-1107 | 2019-10-22 |
| 1962043141 | Erin Ann Williams | Counselor | 1023 S Trade Days Blvd Unit 102, Canton, TX 75103-2434 | 2019-09-30 |
| 1346898079 | Shericka Meeks | Counselor | 304 15th St Ne Ste B, Canton, OH 44714-2523 | 2019-08-27 |
| 1295293876 | Diamond Lawrencethia Gay | Counselor | 4661 Belpar St Nw, Canton, OH 44718-3602 | 2019-03-04 |
| Find all providers in CANTON | ||||
Please comment or provide details below to improve the information on MR. BRYAN J MOORE.
| 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.