Active NPI
Ethel Lamar Moore, M.D.
- Family Medicine Physician
- Harlem, MT
National Provider Identifier
1053437079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- C 6449
- Practice address
- RR 1 Box 67
Harlem, MT 59526-9705 - Phone
- (406) 353-3100
- Fax
- (406) 353-3229
- NPI assigned
- Mar 21, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | C 6449 | AR | Primary |
Addresses
Primary practice location
RR 1 Box 67
Harlem, MT 59526-9705
Mailing address
RR 1 Box 77
Harlem, MT 59526-9706
Phone (406) 353-3137
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| C-6449 | Other | AR | LICENSE |
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C 6449 | AR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frances Mahon Deaconess Hospital | Past | Accepting new patients |
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.
-
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- Glasgow, MT
- NPI 1689685323
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201824000000",
"number": "1053437079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "RR 1 BOX 77",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269706",
"telephone_number": "406-353-3137",
"fax_number": "406-353-3229"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "RR 1 BOX 67",
"city": "HARLEM",
"state": "MT",
"postal_code": "595269705",
"telephone_number": "406-353-3100",
"fax_number": "406-353-3229"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ETHEL",
"middle_name": "LAMAR",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-21",
"last_updated": "2008-02-01",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AR",
"license": "C 6449",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "C-6449",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Harlem, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.