Individual provider Active NPI

Rain Moore, MD

  • Family Medicine Physician
  • Occidental, CA
National Provider Identifier
1043419559
Registry record updated Jun 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A102628 Issued in CA
Practice address
3802 Main St
Occidental, CA 95465
Phone
(707) 874-2444
Fax
(707) 874-2003
NPI assigned
Jul 13, 2007
Last updated
Jun 25, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X A102628 CA Primary

Addresses

Primary practice location

3802 Main St
Occidental, CA 95465

Mailing address

PO Box 1449
Guerneville, CA 95446-1449
Phone (707) 869-5977

Other identifiers 1

IdentifierTypeStateIssuer
1598768962MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20130503000115 CA Order and Referring Only - Family PracticePractitioner - Family Practice 7416194881

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Joseph Health Northern California, LLC Past Accepting new patients
West County Health Centers, Inc. Past Accepting new patients
Sutter Bay Hospitals Past Accepting new patients
SRM Alliance Hospital Services Past Accepting new patients
West County Health Centers, Inc. Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rain.moore@wchealth.eclinicaldirectplus.com

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1435190400000",
    "number": "1043419559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1449",
            "city": "GUERNEVILLE",
            "state": "CA",
            "postal_code": "954461449",
            "telephone_number": "707-869-5977",
            "fax_number": "707-869-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 MAIN ST",
            "city": "OCCIDENTAL",
            "state": "CA",
            "postal_code": "95465",
            "telephone_number": "707-874-2444",
            "fax_number": "707-874-2003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-13",
        "last_updated": "2015-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A102628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598768962",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Occidental, CA

Sources for this page

Verify at the official NPI Registry.