DR. GRANT HARRIS MOORE (NPI# 1710239751) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710239751 |
| Entity Type | Individual |
| Full Name | DR. GRANT HARRIS MOORE |
| Credential | MD |
| Practice Address |
4800 N 22nd St Phoenix AZ 85016-4701 |
| Practice Telephone | 6029551000 |
| Practice Fax Number | 6025084830 |
| Mailing Telephone | 6029551000 |
| Mailing Fax Number | 6025984830 |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2019-05-01 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 55263 | AZ | Allopathic & Osteopathic Physicians |
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
55263 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 349369 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1000 W Carson St, Box 2, Torrance, CA 905022004 | 3102222911 | |
| 1055 S Stapley Dr, Mesa, AZ 852045098 | 4808339100 | 6025084830 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528040417 | Grant K Moore | Otolaryngology | 100 Wason Avenue, Suite 100, Springfield, MA 01107 | 2005-11-16 |
| Street Address |
4800 N 22ND ST |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85016-4701 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235130402 | Jack Owens Sipperley | Ophthalmology | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2005-08-10 |
| 1679120968 | Evelyn Valenzuela | Technician/Technologist | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2019-08-21 |
| 1437588282 | Integrated Anesthesia Services, LLC | Nurse Anesthetist, Certified Registered | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2013-11-02 |
| 1063852259 | Joshua Perkins | Optometrist | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2013-07-02 |
| 1447690607 | Alison Domenica Kitzerow | Optometrist | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2013-07-02 |
| 1477897668 | Ophthalmic Anesthesia Services, Inc | Nurse Anesthetist, Certified Registered | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2012-11-12 |
| 1477814739 | Mahmood El-gasim | Ophthalmology | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2012-06-04 |
| 1538432844 | Barnet Dulaney Perkins Eye Center II Pllc | Clinic/Center | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2012-02-16 |
| 1659641462 | Integrated Eye Care Network | Health Maintenance Organization | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2012-01-10 |
| 1245510379 | Kacey Jane Gilford | Optometrist | 4800 N 22nd St, Phoenix, AZ 85016-4701 | 2011-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851992705 | Heatheranne Baker-oldfield | Counselor | 2415 E Camelback Rd Ste 700, Phoenix, AZ 85016 | 2020-11-06 |
| 1780215681 | Sip Home Systems - Mesa LLC | Home Health | 24th At Camelback, 2375 E. Camelback Rd., Suite 600, Phoenix, AZ 85016 | 2020-01-29 |
| 1760945588 | Wei Wei | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital 1919 E. Thomas Rd., Phoenix, AZ 85016 | 2019-04-09 |
| 1942765623 | Grace Hatfield | Dietitian, Registered | Phoenix Childrens Hospital 1919 E Thomas Rd, Phoenix, AZ 85016 | 2019-02-06 |
| 1861977027 | Dawn Yvette Lima | Occupational Therapy Assistant | 3128 E Cheery Ln, Phoenix, AZ 85016 | 2018-10-03 |
| 1720583685 | Kristin Pauline Hicklin | Registered Nurse | 2930 E Camelback Rd Ste 100, Phoenix, AZ 85016 | 2018-03-24 |
| 1588181622 | Taness Eyre Billington | Pharmacist | 1625 E. Camelback Rd., Phoenix, AZ 85016 | 2017-08-29 |
| 1093239048 | Emma Ross | Psychologist | 1919 E Thomas Rd Bldg 4th, Phoenix, AZ 85016 | 2017-08-01 |
| 1609396985 | Mohammed Waseemuddin | Student in an Organized Health Care Education/Training Program | Phoenix Children's Hospital, 1919 E Thomas Rd, Phoenix, AZ 85016 | 2017-06-27 |
| 1144777632 | Amanda Mazerall | Occupational Therapist | 4333 N 24th Street, Apartment 223, Phoenix, AZ 85016 | 2016-09-01 |
| Find all providers in zip 85016 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477590297 | William M Mcleish, Md, LLC | Ophthalmology | 1331 N 7th St, Suite290, Phoenix, AZ 85006-2754 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205305620 | Barnet Dulaney Perkins Eye Center II Pllc | Ophthalmology | 8763 E Bell Rd Ste 101, Scottsdale, AZ 85260-1318 | 2018-11-14 |
| 1184076028 | Desert Eyesthetics PC | Ophthalmology | 1754 E Boston St, Suite 103, Gilbert, AZ 85295-6238 | 2016-07-04 |
| 1821457532 | Oculoplastic Eye Surgeons of Phoenix P.l.c. | Ophthalmology | 13460 N 94th Dr, Suite L-1, Peoria, AZ 85381-4835 | 2016-02-23 |
| 1538355086 | Kathleen M Duerksen Md PC | Ophthalmology | 5979 E Grant Rd, Suite 115, Tucson, AZ 85712 | 2007-09-19 |
| 1417966607 | Kathleen Marie Duerksen | Ophthalmology | 5979 E Grant Rd, Suite 115, Tucson, AZ 85712 | 2006-08-05 |
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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.