Charlie Jim Moore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2740TG Issued in TX

Practice address

2481 I 40 W
Amarillo, TX 79109

Phone

(806) 358-2205

Fax

(806) 463-2907

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Amarillo Vision Specialists, P.a.

  • Optometrist
  • Amarillo, TX
  • NPI 1104124304
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1003868670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2481 I 40 W",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79109",
            "telephone_number": "806-358-2205",
            "fax_number": "806-463-2907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2481 I 40 W",
            "city": "AMARILLO",
            "state": "TX",
            "postal_code": "79109",
            "telephone_number": "806-358-2205",
            "fax_number": "806-463-2907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLIE",
        "middle_name": "JIM",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2740TG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1331696-07",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Lou Montgomery, M.D.
• Casandra Darlin Montoya, LPC ASSOCIATE
• Mercedes Moomaw
• Melissa Moon, DPT
• Moore Health Services Corporation
• Deborah Lea Moore, M.D.
• Diana Moore, PHARMD
• Donald G Moore, RPH
• Elizabeth Moore, LPC
• John Allen Moore, LPC

• Optometrist in Amarillo, TX
• Providers in Amarillo, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.