SUSAN J MOORE (NPI# 1912982661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912982661 |
| Entity Type | Individual |
| Full Name | SUSAN J MOORE |
| Credential | MD |
| Practice Address |
4247 W Ridge Rd Ste 105 Erie PA 16506-1746 |
| Practice Telephone | 8148382468 |
| Practice Fax Number | 8148352599 |
| Mailing Telephone | 8148382468 |
| Mailing Fax Number | 8148352599 |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-10-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | MD044660E | PA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730526971 | Susan Josephine Moore | Developmental Therapist | 302 Glenwood Dr, 201, Bloomingdale, IL 60108-3318 | 2013-05-29 |
| 1134400864 | Susan John Moore | Nurse Practitioner | 3118 South Lafountain, Indiana Health Center - Kokomo, Kokomo, IN 46902-3710 | 2011-09-08 |
| 1265735435 | Susan Annette Moore | Registered Nurse | 589 Oak Hill Branch Rd, South Webster, OH 45682-9094 | 2010-12-09 |
| 1881903896 | Susan Renee Moore | Specialist | 9030 Monticello Rd, Wesson, MS 39191-9027 | 2010-09-26 |
| 1699097964 | Susan A. Moore | Speech-Language Pathologist | 114 Langdell Road, Hyde Park, VT 05655 | 2010-02-26 |
| 1336470715 | Susan Marie Moore | Social Worker | 3298 Silver Ridge Ct, Hermitage, PA 16148-6082 | 2010-01-25 |
| 1659511350 | Susan P Moore | Physical Therapist | 4747 N Ocean Dr, Ste 261, Lauderdale By The Sea, FL 33308-2947 | 2009-02-20 |
| 1760683817 | Susan Sharon Moore | Dietitian, Registered | 1200 S Arlington Ridge Rd, # 610, Arlington, VA 22202-1952 | 2007-05-29 |
| 1336158450 | Susan M Moore | Nurse Practitioner | 111 N 175th St, Omaha, NE 68118-3579 | 2006-08-07 |
| 1356361430 | Susan J. Moore | Internal Medicine | 112 Crofton Place, Uva Lake Monticello Internal Medicine, Palmyra, VA 22963 | 2006-07-20 |
| Street Address |
4247 W RIDGE RD STE 105 |
| City | ERIE |
| State | PA |
| Zip Code | 16506-1746 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558346577 | Paul J Gausman | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2005-12-13 |
| 1235695511 | Maggie Ho | Nurse Practitioner | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2019-02-12 |
| 1871935965 | Theresa Mullan Vey | Physician Assistant | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2013-07-18 |
| 1396006607 | Lydia Angelique Travnik | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2012-06-04 |
| 1134411051 | Divya Koradia | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2011-05-11 |
| 1841580750 | Philip M St Julien | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2011-04-12 |
| 1386943983 | Natalie Michelle Grow | Dietitian, Registered | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2011-03-22 |
| 1760416275 | Nicolette C Walsh | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506 | 2006-07-10 |
| 1508800459 | Jillian Halmi | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2006-06-15 |
| 1558311092 | Jeffrey D. Kim | Family Medicine | 4247 W Ridge Rd Ste 105, Erie, PA 16506-1746 | 2006-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582838 | Casey Smith | Behavioral Analyst | 4950 W 23rd Street, Suite 1, Erie, PA 16506 | 2019-08-09 |
| 1962916155 | Joseph Michael Moon | Chiropractor | 2921 W 26th St, Erie, PA 16506 | 2017-11-27 |
| 1053851550 | Lake Erie Music Therapy LLC | Music Therapist | 5672 Culpepper Dr., Erie, PA 16506 | 2017-03-02 |
| 1295152700 | Gabrielle Carr | Counselor | 2420 West 23rd St, Erie, PA 16506 | 2014-03-21 |
| 1407296973 | Carolyn Danner-bliss Pediatric Dietitian Services, LLC | Dietitian, Registered | 5105 Coventry Drive, Erie, PA 16506 | 2013-06-28 |
| 1962847772 | Philip J Dunn | Internal Medicine | 3615 Woodhaven Dr, Erie, PA 16506 | 2013-05-07 |
| 1619236684 | Joseph S. Serafini | Hearing Instrument Specialist | 2930 Mckee Rd, Erie, PA 16506 | 2012-05-11 |
| 1063788313 | Tatiana V Khochay | Registered Nurse | 2801 Burgundy Dr., Erie, PA 16506 | 2012-03-30 |
| 1699051318 | Krystyna Teresa Wozniak | Licensed Practical Nurse | 3912 East Boardwalk Place, Erie, PA 16506 | 2011-10-26 |
| 1033436324 | Alexis Jean Mustin | Social Worker | 3210 West 32nd Street, Erie, PA 16506 | 2010-04-26 |
| Find all providers in zip 16506 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235479882 | Jack Gold | Pediatrics | 4425 Upland Dr, Erie, PA 16509-1654 | 2013-02-19 |
| 1467626283 | Ravi Kumar Chekka | Pediatrics | 1611 Peach St Ste 300, Erie, PA 16501-2122 | 2008-04-14 |
| 1811968498 | Stephanie F Russo | Pediatrics | 3910 Caughey Rd, Suite 170, Erie, PA 16506-4096 | 2006-01-31 |
| 1215917166 | Sant Ram | Pediatrics | 2123 W 8th St, Erie, PA 16505-4743 | 2006-01-18 |
| 1124029301 | Lynne M Birkmeyer | Pediatrics | 4022 Zuck Road, Your Pediatric Connection West, Erie, PA 16506-4592 | 2005-08-10 |
| 1780684589 | Andrea Javier Fadrigo | Pediatrics | 4022 Zuck Rd, Erie, PA 16506-4592 | 2005-07-22 |
| 1376549998 | Samuel Allen Fagenholz | Pediatrics | 300 State St Ste 301, Erie, PA 16507-1430 | 2005-06-28 |
| 1093718124 | Joseph C Barber | Pediatrics | 3580 Peach St, Erie, PA 16508-2776 | 2005-05-23 |
| 1487153144 | Pediatric Care Center of Erie, PC | Pediatrics | 1611 Peach St Ste 300, Erie, PA 16501-2122 | 2018-02-08 |
| 1861857534 | Children's Community Care | Pediatrics | 3910 Caughey Rd, Suite 170, Erie, PA 16506-4096 | 2015-12-23 |
| Find all providers in ERIE | ||||
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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.