Stephen T Moore, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

DO0000001305 Issued in TN

Practice address

1101 Neal St
Suite 102
Cookeville, TN 38501-0917

Phone

(931) 526-1581

Fax

(931) 526-5973

NPI assigned

Jun 30, 2006

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 identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405296000000",
    "number": "1083643589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 NEAL ST",
            "address_2": "SUITE 102",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010901",
            "telephone_number": "931-526-1581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 NEAL ST",
            "address_2": "SUITE 102",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385010917",
            "telephone_number": "931-526-1581",
            "fax_number": "931-526-5973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEPHEN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2014-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TN",
            "license": "DO0000001305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3305996",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID/PROVIDER NUMBER",
            "identifier": "621833951",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "3158681",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James F Moore, CRNA
• Jeffrey S Moore, M.D.
• Lee S Moore, MD
• Lisa Moore, BEHAVIOR TECH
• Quadulupe Cordero Moore, BEHAVIOR TECHNICIAN
• Angela Kaye Moralee, LPC-MHSP, TEMP, NCC
• More Than Wordz
• Alyssa Morgan
• Kelli Leeann Morgan, M.S CF-SLP
• Melody Morgan

• Psychiatry Physician in Cookeville, TN
• Providers in Cookeville, TN by specialty
• Psychiatry Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2014; 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.