William Dywayne Moore, EMT

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Practice address

205 Kentucky Ave Suite 1
Stevenson, Al 35772
Stevenson, AL 35772

Phone

(566) 957-3482

Fax

(256) 437-6509

NPI assigned

Jul 19, 2023

Last updated

Jul 27, 2023By the provider in NPPES

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

Other names 1

• Dywayne Moore Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Emergency Medical Technician

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.

• A & R Home Medical Equipment,LLC

  • Oxygen Equipment & Supplies (DME)
  • Stevenson, AL
  • NPI 1497466825
  NPD

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

{
    "created_epoch": "1689724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1083394647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 COUNTY ROAD 255",
            "city": "BRIDGEPORT",
            "state": "AL",
            "postal_code": "357407425",
            "telephone_number": "256-695-7348",
            "fax_number": "256-437-6509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 KENTUCKY AVE SUITE 1",
            "address_2": "STEVENSON, AL 35772",
            "city": "STEVENSON",
            "state": "AL",
            "postal_code": "35772",
            "telephone_number": "566-957-3482",
            "fax_number": "256-437-6509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WILLIAM",
        "middle_name": "DYWAYNE",
        "credential": "EMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-19",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "AL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DYWAYNE",
            "last_name": "MOORE",
            "credential": "EMT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Kilgore Express Pharmacy Inc (North Jackson Pharmacy)
• Ma Mira Inc
• Asha P Mohan, M.D.
• T. Murali Mohan, M.D.
• Amanda Michelle Moore, RESPIRATORY THERAPIS
• North Jackson Dental Care (Stephen Scott Shepherd DMD)
• North Jackson Primary Care
• North Jackson Urgent Care LLC
• Steven Thomas Overby, PHARM.D.
• Scottsboro Family Physicians PC (Stevenson Family Care)

• Customized Equipment (DME) in Stevenson, AL
• Providers in Stevenson, AL by specialty
• Customized Equipment (DME) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.