DR. KEVIN JOSEPH MOORE (NPI# 1164927042) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164927042 |
| Entity Type | Individual |
| Full Name | DR. KEVIN JOSEPH MOORE |
| Credential | MD, MPH |
| Practice Address |
55 Fruit St # Bh616 Boston MA 02114-2621 |
| Practice Telephone | 7745712568 |
| Mailing Telephone | 6177265254 |
| Enumeration Date | 2018-03-24 |
| Last Update Date | 2020-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | 278727 | MA | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154781060 | Kevin Lee Moore | Internal Medicine | 612 Nw 42nd St, Oklahoma City, OK 73118-7004 | 2016-03-04 |
| 1932516788 | Kevin Duane Moore | Licensed Practical Nurse | 121 Swezey Ln, Middle Island, NY 11953-1547 | 2014-07-14 |
| 1982947164 | Kevin Moore | Counselor | 107 Hill St, Apt. 9, Stoneham, MA 02180-3720 | 2013-04-05 |
| 1891917324 | Kevin P. Moore | Marriage & Family Therapist | 7200 W 13th St N Ste 9, Wichita, KS 67212-2968 | 2007-05-03 |
| 1255484036 | Kevin Brian Moore | Chiropractor | 1004 Butler Ave, New Castle, PA 16101-4282 | 2007-01-18 |
| 1275690323 | Kevin Lee Moore | Dentist | 160 S 2nd Ave, Suite B, Clarion, PA 16214-2444 | 2007-01-01 |
| 1225199706 | Kevin Brent Moore | Dentist | 95 Stonecoal Road, Garrett, KY 41630 | 2006-12-12 |
| 1447319645 | Kevin Moore | Counselor | 314 Maxwell Rd Ste 400, Alpharetta, GA 30004-2045 | 2006-12-06 |
| 1619040037 | Kevin R Moore | Case Manager/Care Coordinator | 10528 Nw 57th Ct, Coral Springs, FL 33076-2810 | 2006-11-15 |
| 1023069176 | Kevin Joel Moore | Chiropractor | 3420 Elmore Ave, Davenport, IA 52807-2594 | 2006-05-13 |
| Street Address |
55 FRUIT ST # BH616 |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245620921 | Tiffany Sun | Student in an Organized Health Care Education/Training Program | 55 Fruit St # Bh616, Boston, MA 02114 | 2015-02-02 |
| 1629637079 | Jessica Cervantes | Student in an Organized Health Care Education/Training Program | 55 Fruit St # Bh616, Boston, MA 02114-2621 | 2019-06-10 |
| 1437713344 | Jeffrey Scott Smith | Student in an Organized Health Care Education/Training Program | 55 Fruit St # Bh616, Boston, MA 02114-2621 | 2019-04-25 |
| 1750735593 | Romi Bloom | Dermatology | 55 Fruit St # Bh616, Boston, MA 02114-2621 | 2016-04-18 |
| 1427411149 | Sherry Hui Yu | Dermatology | 55 Fruit St # Bh616, Boston, MA 02114-2621 | 2016-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447636 | Sarah Wieman | Student in an Organized Health Care Education/Training Program | 16 Blossom St Fl 1, Boston, MA 02114-3104 | 2020-11-03 |
| 1932709938 | Brianna Mae Duval | Student in an Organized Health Care Education/Training Program | 58 Colborne Rd, Boston, MA 02135-4103 | 2020-10-28 |
| 1780281279 | Sarah Hamad Alsaggabi | Student in an Organized Health Care Education/Training Program | 55 Traveler St Apt 1310, Boston, MA 02118-2973 | 2020-10-07 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1962018069 | Cara Connors | Student in an Organized Health Care Education/Training Program | 18 Wiget St Apt 1, Boston, MA 02113-2363 | 2020-09-23 |
| 1023624608 | Bernadette Avila | Student in an Organized Health Care Education/Training Program | 19 Peterborough St Apt 5, Boston, MA 02215-4409 | 2020-09-19 |
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| Find all providers in BOSTON | ||||
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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.