Roderick Alan Moore, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

PO00000305 Issued in WA

Practice address

17000 140TH Ave NE
Unit 201
Woodinville, WA 98072-6928

Phone

(425) 481-7055

NPI assigned

Jan 17, 2007

Last updated

Aug 12, 2008By 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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1218499200000",
    "number": "1104978238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17000 140TH AVE NE",
            "address_2": "UNIT 201",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726928",
            "telephone_number": "425-481-7055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17000 140TH AVE NE",
            "address_2": "UNIT 201",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980726928",
            "telephone_number": "425-481-7055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RODERICK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "WA",
            "license": "PO00000305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018365",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jill Truex Miller, MD
• Rebecca Marie Miller, DPT
• Steven Asher Montague, DO
• Ronald O'Neil Moon, LMHC, CDP, MA
• David Richard Moore, M.S, BC-HIS
• Destiny Morey
• Robin Rae Morris, LMHC
• Motivations (James R Fouts)
• Lynne E Munoz
• Kelly Ann McCracken Musselman, PT, DPT, LAT, ATC

• Foot & Ankle Surgery Podiatrist in Woodinville, WA
• Providers in Woodinville, WA by specialty
• Foot & Ankle Surgery Podiatrist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.

Verify at the official NPI Registry.