DR. EVAN C MOORE (NPI# 1548870934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548870934 |
| Entity Type | Individual |
| Full Name | DR. EVAN C MOORE |
| Credential | NP |
| Practice Address |
924 N Country Club Dr Mesa AZ 85201-4108 |
| Mailing Address |
4937 E 2nd St Tucson AZ 85711-1221 |
| Practice Telephone | 4802359434 |
| Mailing Telephone | 4802359434 |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
244443 | AZ | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757509 | Evan Moore | Counselor | 1490 N. Lafayette St, Suite 108, Denver, CO 80218-2391 | 2020-07-14 |
| 1548828916 | Evan S Moore | Dentist | 201 N Dalton St, Madison, NC 27025-1903 | 2019-05-31 |
| 1366922858 | Evan K Moore | Physical Therapy Assistant | 5665 Creekside Forest Dr, Spring, TX 77389-4969 | 2018-08-15 |
| 1902240559 | Evan Michael Moore | Plastic Surgery | 1401 Harrodsburg Rd Ste B75, Lexington, KY 40504-1724 | 2013-04-25 |
| 1699982496 | Evan Robert Moore | Otolaryngology | 5020 E 68th St, Tulsa, OK 74136-3307 | 2007-05-17 |
| 1205053063 | Evan Corlee Moore | Emergency Medicine | 5121 S Cottonwood St, Salt Lake City, UT 84107-5701 | 2007-04-20 |
| Street Address |
924 N COUNTRY CLUB DR |
| City | MESA |
| State | AZ |
| Zip Code | 85201-4108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801821517 | Michael Joseph Franczak | Psychologist | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2006-07-11 |
| 1831717636 | Amanda Ellen Cowart | Nurse Practitioner | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2020-07-08 |
| 1689292468 | Calissa Yepiz | Nurse Practitioner | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2020-07-08 |
| 1568912244 | Stacy Schwaber | Behavior Technician | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2016-10-06 |
| 1548647308 | Kenneth Mack | Technician, Other | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2015-04-30 |
| 1932504107 | Derrrick Mccoy | Technician, Other | 924 N Country Club Dr, Building #1, Mesa, AZ 85201-4108 | 2014-10-29 |
| 1750798690 | Kristina Sharp | Counselor | 924 N Country Club Dr, Building #1, Mesa, AZ 85201-4108 | 2014-07-11 |
| 1255757472 | Aaron Russell Garcia | Counselor | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2014-03-12 |
| 1114343381 | Kellie Jones | Technician, Other | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2014-03-12 |
| 1083039846 | John Gioia | Technician, Other | 924 N Country Club Dr, Mesa, AZ 85201-4108 | 2014-03-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174141980 | Arch Hospice, LLC. | Hospice Care, Community Based | 1209 N. Country Club Dr., Ste. 1, Mesa, AZ 85201 | 2020-07-08 |
| 1861025876 | Summit Bhc Mesa LLC | Clinic/Center | 846 North Center Street Suite 101, Mesa, AZ 85201 | 2020-02-18 |
| 1427600774 | Coleen Chatter | Counselor | 711 N. Evergreenrd. Apt#2088, Mesa, AZ 85201 | 2019-07-16 |
| 1013487800 | Akos Live | Family Medicine | 1902 W. Main Street, Mesa, AZ 85201 | 2018-12-05 |
| 1760990329 | Sage Counseling, Inc. | Community/Behavioral Health | 460 N. Mesa Drive, Suites 207 and 209, Mesa, AZ 85201 | 2018-01-17 |
| 1336590025 | Horizon Health and Wellness, Inc. | Assisted Living Facility | 453 West Sunset Circle, Mesa, AZ 85201 | 2016-06-24 |
| 1356711279 | Cheryl Agosto | Registered Nurse | 1025 N. Country Club Dr, Mesa, AZ 85201 | 2015-10-05 |
| 1861877961 | Richard Roble | Speech-Language Pathologist | 125 N. Country Club Dr., Mesa, AZ 85201 | 2015-07-30 |
| 1326440991 | Demetria Harris | Counselor | 455 N. Mesa Drive #11, Mesa, AZ 85201 | 2014-09-25 |
| 1588002489 | Zhen Liu | Acupuncturist | 210n. Center St, #102, Mesa, AZ 85201 | 2013-06-13 |
| Find all providers in zip 85201 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609487149 | Sunitha Jose | Nurse Practitioner | 3308 N Higley Rd, Mesa, AZ 85215-9781 | 2020-08-10 |
| 1447877972 | Reena Pathak | Nurse Practitioner | 1111 S Stapley Dr # 5060, Mesa, AZ 85204-5059 | 2020-07-01 |
| 1760021885 | Matthew Deise | Nurse Practitioner | 460 N Mesa Dr Ste 201, Mesa, AZ 85201-5957 | 2020-01-06 |
| 1639713621 | Summit Place Mental Health, LLC | Nurse Practitioner | 625 W Southern Ave Ste E, Mesa, AZ 85210-5018 | 2019-11-01 |
| 1063062149 | Makenna Francis | Nurse Practitioner | 2730 S. Val Vista Dr, 146, Mesa, AZ 85215 | 2019-09-19 |
| 1891341947 | James M Theiss | Nurse Practitioner | 5439 E Ellis St, Mesa, AZ 85205-5470 | 2019-08-14 |
| 1134527534 | Susan Willever | Nurse Practitioner | 11331 E Starfire Cir, Mesa, AZ 85212-7062 | 2014-12-17 |
| 1326443003 | Jennifer Anderson | Nurse Practitioner | 6262 E Brown Rd Unit 43, Mesa, AZ 85205-4846 | 2014-10-24 |
| 1356616205 | Sukanlaya Hughes | Nurse Practitioner | 2444 E. Southern Ave. Ste. 103, Mesa, AZ 85204 | 2012-03-11 |
| 1942403076 | Shosamana | Nurse Practitioner | 3740 E Southern Ave Ste 207, Mesa, AZ 85206-2512 | 2007-06-06 |
| Find all providers in MESA | ||||
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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.