DR. KEVIN R MOORE


Address: 100 N Medical Dr, Salt Lake City, UT 84113-1103
Phone: 8016621900

DR. KEVIN R MOORE (NPI# 1306940739) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1306940739
Entity Type Individual
Full Name DR. KEVIN R MOORE
Credential MD
Practice Address 100 N Medical Dr
Salt Lake City
UT 84113-1103
Mailing Address 869 E 4500 S
Pmb 511
Salt Lake City
UT 84107-3049
Practice Telephone 8016621900
Mailing Telephone 8014870451
Mailing Fax Number 8014872467
Enumeration Date 2006-09-07
Last Update Date 2008-06-17
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 2085P0229X Radiology
Specialization: Pediatric Radiology
273877-1205 UT Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
UT EDUCATORS MUTUAL 870355724KRM 01
UT SELECTHEALTH 107007661103 01
UT DESERET MUTUAL 35834 01
UT UUHN 7541 01
UT AETNA 8550895 01
UT PUBLIC EMPLOYEES HEALTH 83716 01
UT CIGNA 8061904 01
UT UNITED HEALTHCARE 1600788 01
UT ALTIUS QM0000027099 01

Other Providers KEVIN MOORE

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

Office Location

Street Address 100 N MEDICAL DR
City SALT LAKE CITY
State UT
Zip Code 84113-1103

Providers in the same location

NPI Name Taxonomy Address Enumeration
1598763112 Michael Wayne Boyer Pediatrics 100 N Medical Dr, Bmt, Salt Lake City, UT 84113-1103 2005-07-08
1679719215 Kristen Haacke Nurse Practitioner 100 N Medical Dr, Salt Lake City, UT 84113-1103 2009-01-04
1508001736 Juliann Wintch Allred Psychiatry & Neurology 100 N Medical Dr, Clinical Neurosciences Center, Neurology, Salt Lake City, UT 84132-0001 2008-12-02
1811141500 Jennifer Grace O'donohoe Student in an Organized Health Care Education/Training Program 100 N Medical Dr, Salt Lake City, UT 84113-1103 2008-11-08
1033362264 Erin Kristin Zinkhan Pediatrics 100 N Medical Dr, Residency Office, Salt Lake City, UT 84113-1103 2008-10-31
1962652966 Rachael D Rich Nurse Practitioner 100 N Medical Dr, Salt Lake City, UT 84113-1103 2008-09-25
1528229101 Julia Kelsey Gunther Pediatrics 100 N Medical Dr, Salt Lake City, UT 84113-1103 2008-06-17
1225295520 Primary Children's Medical Center General Acute Care Hospital 100 N Medical Dr, Primary Children's Medical Center Pediatric Cardiology, Salt Lake City, UT 84113-1103 2008-05-22
1942476569 Pediatric Behavioral Health Pediatrics 100 N Medical Dr, Peds Behavioral Health, Salt Lake City, UT 84113-1103 2008-05-03
1871769471 Machelle Ross Bateman Nurse Practitioner 100 N Medical Dr, Salt Lake City, UT 84113-1103 2008-05-03
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1386111060 Melissa Marie Dixon Psychologist Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 2018-10-31
1366965618 Ashley Stuart Psychologist 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 2017-07-19
1487945135 Justin C Wheeler Pediatrics 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 2011-04-29
1154612117 Dana Boucek Pediatrics 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 2011-04-26
1285959502 Anna Katherine Eyre Ermarth Pediatrics 81 Mario Capecchi, Salt Lake City, UT 84113 2010-03-30
1457682072 Elizabeth K Cho Nurse Practitioner 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 2010-01-21
1528290848 Nancy Crandell Brown Nurse Practitioner 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 2009-08-20
1679708481 Primary Children's Medical Center General Acute Care Hospital 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 2009-05-22
1467697235 Tara Hook Physical Therapist 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 2008-12-09
1144474768 Jennifer K Workman Pediatrics 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 2008-11-10
Find all providers in zip 84113

Taxonomy Information

Taxonomy Code 2085P0229X
Grouping Allopathic & Osteopathic Physicians
Classification Radiology
Specialization Pediatric Radiology

Taxonomy Definition

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source]
- Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1720198716 William D. Winters Radiology 100 No Mario Capecchi Dr., Salt Lake City, UT 84113 2006-08-30
1215940465 Karin L. Hoeg Radiology 100 No. Mario Capecchi Dr., Salt Lake City, UT 84113 2006-08-15
1053664680 Ihc Health Services Inc Radiology 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2012-10-19
1730394131 Ryan W. Arnold Radiology 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2007-05-11
1083739270 Henry J Baskin Jr. Radiology 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 2007-03-20
1790875300 Kathleen Ann Murray Radiology Fairfax Road At Virginia Street, Shriners Hosptials for Children, Salt Lake City, UT 84103-4399 2006-10-13
1447351978 Giosue Peter Feola Radiology 100 N Medical Dr, Salt Lake City, UT 84113-1103 2006-09-26
1063513596 Constance K Maves Radiology 100 N Medical Dr, Salt Lake City, UT 84113-1103 2006-09-26
1154422681 Gary L Hedlund Radiology 100 N Medical Dr, Salt Lake City, UT 84113-1103 2006-09-26
1861502254 Pediatric Radiology, P.C. Radiology 100 N Medical Dr, Salt Lake City, UT 84113-1103 2006-08-30
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Competitor

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City SALT LAKE CITY
Zip Code 84113

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Dataset Information

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.

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