John Eric Moore, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

01022001116 Issued in VA

Practice address

55 W Tietan St
Walla Walla, WA 99362-4498

Phone

(509) 525-3720

Fax

(509) 522-1593

NPI assigned

Aug 1, 2005

Last updated

Mar 25, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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 MT

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 Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Yellowstone City-County Health Dept

  dba RiverStone Health

  • Federally Qualified Health Center (FQHC)
  • Billings, MT
  • NPI 1841219698
  Medicare reassignment NPD
• Yellowstone City-County Health Department

  dba RiverStone Health HCH

  • Federally Qualified Health Center (FQHC)
  • Billings, MT
  • NPI 1528575685
  NPD

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

{
    "created_epoch": "1122854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585094400000",
    "number": "1063412070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40220 SADDLEBROOK ST",
            "city": "MURRIETA",
            "state": "CA",
            "postal_code": "925636100",
            "telephone_number": "951-600-9640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 W TIETAN ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624498",
            "telephone_number": "509-525-3720",
            "fax_number": "509-522-1593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40220 Saddlebrook St",
            "address_purpose": "LOCATION",
            "city": "Murrieta",
            "state": "CA",
            "postal_code": "925636100",
            "country_code": "US",
            "telephone_number": "951-600-9640",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-01",
        "last_updated": "2020-03-25",
        "certification_date": "2020-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "01022001116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Marie Montoya, MSW
• Megan Stephanie Montrose Sandiford
• Sean Moon
• Cloise Barton Moore, MD
• Janet Moore
• Kenneth E Moore, PA C
• Leigh Alison Moore, PHARM.D.
• Michael Roy Moore, M.D.
• Pat S Morales, MSN, RN, CPPN, CGRA
• Morasch Medical, PC (Heritage Clinic)

• Family Medicine Physician in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Family Medicine Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2020; 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.