DAVID L MOORE (NPI# 1891133369) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891133369 |
| Entity Type | Individual |
| Full Name | DAVID L MOORE |
| Credential | NP |
| Practice Address |
555 Black Oak Dr Medford OR 97504 |
| Mailing Address |
2825 E Barnett Rd Medford OR 97504-8332 |
| Practice Telephone | 9077135258 |
| Enumeration Date | 2013-06-06 |
| Last Update Date | 2019-08-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AP60627765 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
201906750-NP-PP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
APN0000017603 | TN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
116687 | AK | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | LNI WVH | P01607185 | 01 |
| WA | 1891133369 | 05 | |
| WA | RR PTAN WVH | P01607185 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 225 Front St Ste 202, Juneau, AK 998011244 | 9075864230 | |
| 2825 E Barnett Rd, Medford, OR 975048332 | 9077135258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053975979 | David Brent Moore | Speech-Language Pathologist | 2201 W Iowa Ave Ste 5, Chickasha, OK 73018-2732 | 2019-04-25 |
| 1477077683 | David Allan Moore | Taxi | 3159 Lake Road, Horseheads, NY 14845 | 2017-07-29 |
| 1609221209 | David Christopher Moore | Anesthesiology | 75 Francis St # Cw-l1, Boston, MA 02115-6110 | 2016-05-02 |
| 1114389780 | David Jan Moore | Emergency Medicine | 6015 Tyndall Ave, Bronx, NY 10471-1812 | 2016-03-23 |
| 1679915060 | David E Moore | Dentist | 11 N 11th Ave Ste 107, Yakima, WA 98902-3085 | 2013-07-25 |
| 1346503349 | David Moore | Family Medicine | 6282 Edgecreek Ln, Columbus, OH 43231-7645 | 2012-06-25 |
| 1386904043 | David Earl Moore | Specialist | 500 Foothill Blvd (research), George E. Wahlen Va Healthcare System, Salt Lake City, UT 84148 | 2012-05-29 |
| 1821357468 | David John Moore | Acupuncturist | 1210 Lehigh St, Boulder, CO 80305-6352 | 2012-05-15 |
| 1922306760 | David Jonathan Moore | Specialist/Technologist, Other | 674 Mesa Ct, Rifle, CO 81650-2529 | 2011-03-02 |
| 1497989933 | David B Moore | Registered Nurse | 4801 College Blvd., Leawood, KS 66211-1628 | 2009-05-13 |
| Street Address |
555 BLACK OAK DR |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588661912 | Nancy J. Keeley | Nurse Practitioner | 555 Black Oak Dr, Suite 100, Medford, OR 97504-8447 | 2005-06-30 |
| 1497218614 | Rachel Dunn | Nurse Practitioner | 555 Black Oak Dr, Medford, OR 97504-8447 | 2019-04-14 |
| 1073079430 | Kathryn Hardaway | Registered Nurse | 555 Black Oak Dr, Medford, OR 97504-8447 | 2019-02-11 |
| 1124582820 | Dana Andrew Teszler | Nurse Practitioner | 555 Black Oak Dr, Medford, OR 97504-8447 | 2019-01-27 |
| 1518435585 | Jesse Hodson | Nurse Practitioner | 555 Black Oak Dr, Medford, OR 97504-8447 | 2018-11-08 |
| 1578089108 | Jennifer May Foltz | Nurse Practitioner | 555 Black Oak Dr, Medford, OR 97504-8447 | 2017-08-15 |
| 1194255950 | Greg D Smith | Nurse Practitioner | 555 Black Oak Dr, Medford, OR 97504 | 2017-06-14 |
| 1386192391 | Sarah Elizabeth White | Pharmacist | 555 Black Oak Dr, Medford, OR 97504-8447 | 2016-09-19 |
| 1326474800 | Laura Marie Ulloa | Social Worker | 555 Black Oak Dr, Medford, OR 97504-8447 | 2013-09-17 |
| 1487092045 | Ernesto Jimenez | Family Medicine | 555 Black Oak Dr, Medford, OR 97504-8447 | 2013-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1770005407 | Suzanne Ellen Sanderson | Nurse Practitioner | 2620 E Barnett Rd Ste H, Medford, OR 97504-8383 | 2017-07-14 |
| 1194189902 | Josephine Magpantay Gaviola | Nurse Practitioner | 101 Main St Ste 116, Medford, MA 02155-4530 | 2016-04-07 |
| 1033514286 | Lauren E Hodgdon | Nurse Practitioner | 1698 E Mcandrews Rd Ste 200, Medford, OR 97504 | 2014-10-30 |
| 1962820209 | Jessica Anne Marie Gunn | Nurse Practitioner | 21 Ohio Trl, Medford, NJ 08055-8931 | 2014-04-03 |
| 1912333451 | Travis Adam Day | Nurse Practitioner | 70 Bower Dr Ste 110, Medford, OR 97501-3689 | 2013-09-16 |
| 1184058703 | Ashley Riley | Nurse Practitioner | 101 Main St Ste 107, Medford, MA 02155-4530 | 2013-08-30 |
| 1578841169 | Shannon Jamerson | Nurse Practitioner | 619 N Front St, Medford, OK 73759-2704 | 2011-07-29 |
| 1891081113 | Debra Jeanne Zenner | Nurse Practitioner | 143 South Gibson St., Medford, WI 54451 | 2011-06-24 |
| 1366763336 | Edward William Walton | Nurse Practitioner | 2 Pinecrest Dr, Medford, NJ 08055-8513 | 2010-06-14 |
| Find all providers in MEDFORD | ||||
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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.