Rodrick Wayne Moore Sr., CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

95001146 Issued in CA

Practice address

4060 Whittier Blvd
Los Angeles, CA 90023-2526

Phone

(323) 268-5514

NPI assigned

Jun 12, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Down Below Certified Registered Nursing Anesthesia PCGroup PAC ID 1557802733, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Barstow Community Hospital Hospital, Barstow, CA, CCN 050298

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

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.

• Down Below Certified Registered Nursing Anesthesia PC

  • Certified Registered Nurse Anesthetist
  • Barstow, CA
  • NPI 1104660455

  Nurse Anesthetist, Certified Registered

  Medicare reassignment Care Compare group NPD
• G & G Anesthesia LLC

  • Certified Registered Nurse Anesthetist
  • Maryville, IL
  • NPI 1487020111

  Nurse Anesthetist, Certified Registered

  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Hospital of Barstow Inc

  • General Acute Care Hospital
  • Barstow, CA
  • NPI 1780655670
  Care Compare affiliation

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

{
    "created_epoch": "1560297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560297600000",
    "number": "1053970103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 MENDOCINO WAY",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925713732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4060 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900232526",
            "telephone_number": "323-268-5514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RODRICK",
        "middle_name": "WAYNE",
        "name_suffix": "Sr.",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-12",
        "last_updated": "2019-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CA",
            "license": "95001146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Moore, M.S. CCC-SLP
• Rebekah Moore
• Richard William Moore, OTR/L
• Rio Desiree Moore
• Robynn L Moore
• Ryan Michael Moore, PT
• Sharon Helen Moore, MFT
• Sophia Angela Moore, LCSW
• Stacey Moore, AU.D.
• Tamu H Moore

• Certified Registered Nurse Anesthetist in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Certified Registered Nurse Anesthetist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.