Individual provider Active NPI

Frederick Stephen Moore, MD

  • Gastroenterology Physician
  • Gainesville, GA
National Provider Identifier
1104876440
Registry record updated Oct 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
022254 Issued in GA
Practice address
2324 Limestone Overlook
Gainesville, GA 30501-7443
Phone
(770) 536-8109
Fax
(770) 536-3203
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 022254 GA Primary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 022254 GA
Gastroenterology Physician 207RG0100X 164074 MT

Addresses

Primary practice location

2324 Limestone Overlook
Gainesville, GA 30501-7443

Mailing address

PO Box 907790
Gainesville, GA 30501-0912
Phone (770) 536-8109

Other practice location 1

2800 11th Ave S Ste 12
Great Falls, MT 59405-5263
Phone (406) 731-8360

Other identifiers 1

IdentifierTypeStateIssuer
000224738AMedicaidGA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address fmoore31638@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, ME2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050323000356 GA Practitioner - Gastroenterology 1850347840 Reassigns benefits to 1 organization
I20190123000572 ME Practitioner - Gastroenterology 1850347840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Medical College of Georgia School of Medicine, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eastern Maine Medical CenterGroup PAC ID 2062315161, 659 clinicians

Practice addresses (Care Compare)

417 State St
Suite 121
Bangor, ME 04401-6630
Phone (207) 973-4266

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.1 of 100Reported as group
Quality
64.8
Promoting interoperability
96
Improvement activities
40
Cost
68.87

Merit-based Incentive Payment System (MIPS)

Final score
87.83 of 100Reported as group
Quality
80.36
Promoting interoperability
100
Improvement activities
40
Cost
79.08

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
164074MTMDGastroenterology Physician
022254GAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gainesville Endoscopy Center, LLC Current Accepting new patients
Northeast Georgia Physicians Group Inc CurrentSince Jan 17, 2024 Accepting new patients
Braselton Endoscopy Center, LLC PastSince Sep 23, 2011 Accepting new patients

Locations

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

2324 Limestone Overlook
Gainesville, GA 30501
Phone 77053681092140

743 Spring St NE
Gainesville, GA 30501
Phone (770) 219-5915

Organizations & group practices 4

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760486400000",
    "number": "1104876440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 907790",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305010912",
            "telephone_number": "770-536-8109",
            "fax_number": "770-536-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 LIMESTONE OVERLOOK",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305017443",
            "telephone_number": "770-536-8109",
            "fax_number": "770-536-3203"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2800 11th Ave S Ste 12",
            "address_purpose": "LOCATION",
            "city": "Great Falls",
            "state": "MT",
            "postal_code": "594055263",
            "country_code": "US",
            "telephone_number": "406-731-8360",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "FREDERICK",
        "middle_name": "STEPHEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2025-10-15",
        "certification_date": "2025-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "GA",
            "license": "022254",
            "primary": true
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "GA",
            "license": "022254",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MT",
            "license": "164074",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000224738A",
            "state": "GA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "fmoore31638@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2324 Limestone Overlook",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305017443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.