Active NPI
Stephen R Moore, MD
- Pulmonary Disease Physician
- Middletown, OH
National Provider Identifier
1083681076
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pulmonary Disease Physician
- License
- 35054764
- Practice address
- 1040 Summitt SQ
Middletown, OH 45042-3400 - Phone
- (513) 425-0533
- Fax
- (513) 425-0527
- NPI assigned
- Mar 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pulmonary Disease Physician | 207RP1001X | 35054764 | OH | Primary |
Addresses
Primary practice location
1040 Summitt SQ
Middletown, OH 45042-3400
Mailing address
1040 Summitt SQ
Middletown, OH 45042-3400
Phone (513) 425-0533
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0766827 | Medicaid | OH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35054764 | OH | MD | Pulmonary Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Neurological & Sleep Disorders Inc | Pulmonary Disease | Past | Accepting new patients |
| Your MD, LLC | Past | Accepting new patients | |
| Noble Allman DC Inc | Past | Accepting new patients |
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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Pulmonary Disease
-
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- Monroe, OH
- NPI 1982887832
-
- Sleep Medicine (Family Medicine) Physician
- Cincinnati, OH
- NPI 1326200205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1141776000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210809600000",
"number": "1083681076",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1040 SUMMITT SQ",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450423400",
"telephone_number": "513-425-0533",
"fax_number": "513-425-0527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1040 SUMMITT SQ",
"city": "MIDDLETOWN",
"state": "OH",
"postal_code": "450423400",
"telephone_number": "513-425-0533",
"fax_number": "513-425-0527"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "STEPHEN",
"middle_name": "R",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-08",
"last_updated": "2008-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "OH",
"license": "35054764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0766827",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Middletown, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.