Individual provider Active NPI

Harold Randall Moore, D.P.M.

  • Podiatrist
  • Fort Collins, CO
National Provider Identifier
1023096989
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
339 Issued in CO
Practice address
1001 E Harmony Rd Unit a
#310
Fort Collins, CO 80525-8888
Phone
(970) 472-8700
NPI assigned
Jan 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X 339 CO Primary
Podiatrist 213E00000X 448 MO
Podiatrist 213E00000X 116 WY

Addresses

Primary practice location

1001 E Harmony Rd Unit a
#310
Fort Collins, CO 80525-8888

Mailing address

1001 E Harmony Rd Unit a
#310
Fort Collins, CO 80525-8888
Phone (970) 472-8700

Other identifiers 2

IdentifierTypeStateIssuer
116212800MedicaidWY
95885269MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
448MOMDPodiatrist
116WYMDPodiatrist
116NYMDAudiologist
339COMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Clinic, LLC PastSince Aug 18, 2003 Accepting new patients
Harold Moore PastSince Jan 1, 1990 Accepting new patients
Skye Yoga Counseling, LLC PastSince Sep 22, 2024 Accepting new patients

Organizations & group practices 3

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": "1136160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279756800000",
    "number": "1023096989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 E HARMONY RD UNIT A",
            "address_2": "#310",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258888",
            "telephone_number": "970-472-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 E HARMONY RD UNIT A",
            "address_2": "#310",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805258888",
            "telephone_number": "970-472-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HAROLD",
        "middle_name": "RANDALL",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-02",
        "last_updated": "2010-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "CO",
            "license": "339",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MO",
            "license": "448",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WY",
            "license": "116",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "116212800",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "95885269",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Collins, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.