Active NPI
Vincent Joseph Moore, MD
- Obstetrics & Gynecology Physician
- Rhinelander, WI
National Provider Identifier
1083654628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 20928
- Practice address
- 2251 N Shore Dr
Rhinelander, WI 54501-8360 - Phone
- (715) 361-4738
- NPI assigned
- Jun 8, 2006
- Last updated
- Dec 15, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 20928 | WI | Primary |
Addresses
Primary practice location
2251 N Shore Dr
Rhinelander, WI 54501-8360
Mailing address
2251 N Shore Dr
Suite 100
Rhinelander, WI 54501-8360
Phone (715) 361-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34080300 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Big Bend Medical Group | Obstetrics & Gynecology | Past | Accepting new patients |
Organizations & group practices 1
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.
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Obstetrics & Gynecology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323907200000",
"number": "1083654628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2251 N SHORE DR",
"address_2": "SUITE 100",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545018360",
"telephone_number": "715-361-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2251 N SHORE DR",
"city": "RHINELANDER",
"state": "WI",
"postal_code": "545018360",
"telephone_number": "715-361-4738"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "VINCENT",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2011-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "WI",
"license": "20928",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "34080300",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rhinelander, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.