Robert W Moore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD017168 Issued in LA

Practice address

225 Pecan Park Ave
Alexandria, LA 71303-3361

Phone

(318) 442-1002

Fax

(318) 442-1008

NPI assigned

Oct 13, 2005

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 LA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lsu Health Sciences Center Shreveport Faculty Group Practice

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1013374222
  Medicare reassignment NPD
• Lsumc-S Family Practice Medical

  dba LSUHSC-S Family Medicine Residency Program

  • Family Medicine Physician
  • Alexandria, LA
  • NPI 1992888101
  Medicare reassignment NPD
• Lsumc-S Family Practice Medical Center in Alexandria

  dba LSUHSC-S Family Medicine Residency Program

  • Family Medicine Physician
  • Alexandria, LA
  • NPI 1942889852
  NPD (past)

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

{
    "created_epoch": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261353600000",
    "number": "1013906957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 PECAN PARK AVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033361",
            "telephone_number": "318-442-1002",
            "fax_number": "318-442-1008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 PECAN PARK AVE",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033361",
            "telephone_number": "318-442-1002",
            "fax_number": "318-442-1008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-13",
        "last_updated": "2009-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD017168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1359505",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Fletcher Moore, PHARMD
• Angela Moore
• Brandon Kenneth Moore, PHARMD
• Bryce Moore
• Devon Moore
• Robertha Monique Moore, LPC
• Ryan Taylor Moore, CRNA
• Barbara G Moorehead, PSY.D.
• Janice Lorraine Moorman, CAC
• Hannah Morace

• Family Medicine Physician in Alexandria, LA
• Providers in Alexandria, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2009; 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.