Active NPI
Elizabeth Jeanne-Anne Moore, MD
- Pediatrics Physician
- New Orleans, LA
National Provider Identifier
1073774345
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- MD.204558
- Practice address
- 1514 Jefferson Hwy
New Orleans, LA 70121-2429 - Phone
- (504) 842-3900
- Fax
- (504) 842-0011
- NPI assigned
- Jun 19, 2008
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 29699 | AL | |
| Pediatrics Physician | 208000000X | 54988 | TN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Pediatrics Physician | 208000000X | MD.204558 | LA | Primary |
Addresses
Primary practice location
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Mailing address
1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3900
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2153455 | Medicaid | LA | |
| 01176840 | Medicaid | MS |
Other names 1
- Elizabeth Jeanne-Anne Waller
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29699 | AL | MD | Pediatrics Physician |
| MD.204558 | LA | MD | Pediatrics Physician |
| 54988 | TN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients | |
| Ochsner Clinic LLC | Current | Accepting new patients |
Locations
1315 Jefferson Hwy
New Orleans, LA 70121
Phone (504) 842-5200
2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650
1514 Jefferson Hwy
New Orleans, LA 70121
Interoperability endpoints
- emoore690048@direct.ochsner.org
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1073774345",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1514 JEFFERSON HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701212429",
"telephone_number": "504-842-3900",
"fax_number": "504-842-0011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1514 JEFFERSON HWY",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701212429",
"telephone_number": "504-842-3900",
"fax_number": "504-842-0011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ELIZABETH",
"middle_name": "JEANNE-ANNE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-19",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "AL",
"license": "29699",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TN",
"license": "54988",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "LA",
"license": "MD.204558",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2153455",
"state": "LA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01176840",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "ELIZABETH",
"last_name": "WALLER",
"middle_name": "JEANNE-ANNE",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in New Orleans, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; 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.