Individual provider Active NPI

Angela Marie Moore, D.O.

  • Pediatrics Physician
  • Circleville, OH
National Provider Identifier
1013131184
Registry record updated Dec 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
34.008964 Issued in OH
Practice address
798 N Court St
Circleville, OH 43113-1262
Phone
(740) 420-3000
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 34.008964 OH Primary

Addresses

Primary practice location

798 N Court St
Circleville, OH 43113-1262

Mailing address

798 N Court St
Circleville, OH 43113-1262
Phone (740) 420-3000

Other identifiers 1

IdentifierTypeStateIssuer
2748503MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address adena.peds@adena.medicity.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415002100 OH Practitioner - Pediatric Medicine 4385871292 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Adena Medical Group LLCGroup PAC ID 1153456579, 384 clinicians

Practice addresses (Care Compare)

110 Vaugh Lane
Suite 20
Chillicothe, OH 45601
Phone (740) 779-7201

798 N Court St
Circleville, OH 43113-1262
Phone (740) 420-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
34.008964OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Adena Medical Group LLC Pediatrics CurrentSince Apr 1, 2021 Accepting new patients

Locations

272 Hospital Rd
Ste 6
Chillicothe, OH 45601

4439 State Route 159
#10
Chillicothe, OH 45601

798 N Court St
Circleville, OH 43113
Phone (740) 420-3000

5030 N Walnut St
South Bloomfield, OH 43103
Phone (740) 983-0015

12340 State Route 104
Waverly, OH 45690
Phone (740) 941-5180

Interoperability endpoints

  • Direct secure messaging: amoore1060703@direct.osumc.edu

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640304000000",
    "number": "1013131184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "798 N COURT ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131262",
            "telephone_number": "740-420-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "798 N COURT ST",
            "city": "CIRCLEVILLE",
            "state": "OH",
            "postal_code": "431131262",
            "telephone_number": "740-420-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2021-12-24",
        "certification_date": "2021-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "34.008964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2748503",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "adena.peds@adena.medicity.net",
            "affiliation": "N",
            "address_1": "4439 State Route 159 # Gteg10",
            "city": "Chillicothe",
            "state": "OH",
            "country_code": "US",
            "postal_code": "456018207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Circleville, OH

Sources for this page

Verify at the official NPI Registry.