BENJAMIN C MOORE (NPI# 1518131754) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518131754 |
| Entity Type | Individual |
| Full Name | BENJAMIN C MOORE |
| Other Name | BEN C MOORE |
| Credential | M.D. |
| Practice Address |
421 S 28th Ave Suite 200 Hattiesburg MS 39401-7206 |
| Mailing Address |
415 S 28th Ave Hattiesburg MS 39401-7246 |
| Practice Telephone | 6012685640 |
| Practice Fax Number | 6012613507 |
| Mailing Telephone | 6012685640 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2020-07-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 21901 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | UNITED HEALTHCARE | 3493860 | 01 |
| MS | HEALTHSPRING | 6060931 | 01 |
| MS | CIGNA | 4738806 | 01 |
| MS | 04456312 | 05 | |
| MS | AETNA | 9496951 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447887096 | Benjamin J Moore | Physician Assistant | 4920 S 30th St Ste 103, Omaha, NE 68107-1656 | 2020-03-24 |
| 1427562685 | Benjamin Moore | Physical Medicine & Rehabilitation | 8301 E Prentice Ave Ste 207, Greenwood Village, CO 80111-2905 | 2017-11-27 |
| 1043668791 | Benjamin Moore | Physical Therapist | 4909 Nolensville Rd, Nashville, TN 37211-5411 | 2016-06-02 |
| 1609241819 | Benjamin Moore | Massage Therapist | 2207 N Molter Rd Ste 250, Liberty Lake, WA 99019-7582 | 2015-12-14 |
| 1992186415 | Benjamin Ross Moore | Dentist | 15 Rawls Rd, Suite 200, Angier, NC 27501-6033 | 2015-06-10 |
| 1568801504 | Benjamin Moore | Counselor | 2305 Old County Rd, Pocahontas, AR 72455-4148 | 2013-06-24 |
| 1710208848 | Benjamin Virlow Moore | Social Worker | 575 East 100 South, Price, UT 84501 | 2010-06-11 |
| 1548459498 | Benjamin Alan Moore | Optometrist | 401 W Main St, Suite A, John Day, OR 97845-1075 | 2007-10-16 |
| 1033240981 | Benjamin R Moore | Physical Therapist | 555 East Broadway, Suite 100, Jackson, WY 83001 | 2007-03-09 |
| 1558342196 | Benjamin E Moore | Specialist | 2 Shircliff Way, Ste 925, Jacksonville, FL 32204-4753 | 2005-11-10 |
| Street Address |
421 S 28TH AVE SUITE 200 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-7206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073539409 | Laura N Keith | Nurse Practitioner | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2006-07-15 |
| 1811302995 | Hattiesburg Clinic, Pa | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2014-06-26 |
| 1922435130 | Marlena Marie Bradley | Nurse Practitioner | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2013-10-02 |
| 1659635027 | Amanda Dawn Sellers | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2012-06-29 |
| 1265744437 | Lauren Ayres Bethea | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2010-07-05 |
| 1891970521 | Marie M Darby | Obstetrics & Gynecology | 421 S 28th Ave, Suite 120, Hattiesburg, MS 39401-7206 | 2007-12-31 |
| 1447431465 | Jennifer Cain Bailey | Obstetrics & Gynecology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-11-19 |
| 1518175314 | Hattiesburg Clinic, P.a. | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7206 | 2007-05-18 |
| 1336351659 | Leigh Anne Strong | Pathology | 421 S 28th Ave, Hattiesburg, MS 39401-7236 | 2007-05-07 |
| 1982785820 | Hattiesburg Clinic Pa | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2006-10-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871732032 | Marcus Leon Hogan | Obstetrics & Gynecology | 6111 U S Highway 49, Hattiesburg, MS 39401-7170 | 2009-02-11 |
| 1922184274 | Womens Pavilion of South Mississippi Pllc | Obstetrics & Gynecology | 5003 Hardy St Ste 350, Hattiesburg, MS 39402-1323 | 2006-10-30 |
| 1972576460 | Marion Catherine Sessums | Obstetrics & Gynecology | 6524 U S Highway 98, Hattiesburg, MS 39402-8569 | 2006-02-07 |
| 1821093691 | John Michael Woods | Obstetrics & Gynecology | 62 Old Airport Rd, Hattiesburg, MS 39401 | 2005-06-16 |
| 1760882815 | Womens Pavilion of South Mississippi Pllc | Obstetrics & Gynecology | 5003 Hardy St, Suite 300, Hattiesburg, MS 39402-1319 | 2014-08-26 |
| 1629403480 | Forrest County General Hospital | Obstetrics & Gynecology | 1 Lincoln Pkwy, Suite 103, Hattiesburg, MS 39402-3262 | 2013-09-11 |
| 1629418074 | Shantele Hinton Bolton | Obstetrics & Gynecology | 6524 U S Highway 98, Hattiesburg, MS 39402-8569 | 2013-06-30 |
| 1659635027 | Amanda Dawn Sellers | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2012-06-29 |
| 1265744437 | Lauren Ayres Bethea | Obstetrics & Gynecology | 421 S 28th Ave, Suite 200, Hattiesburg, MS 39401-7206 | 2010-07-05 |
| 1497918825 | Andrea Mcdaniel Carter | Obstetrics & Gynecology | 6524 U S Highway 98, Hattiesburg, MS 39402-8569 | 2008-07-07 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
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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.