Paul E Moran III, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD18878 Issued in TN

Practice address

1321 Sunset Dr
Suite 22
Johnson City, TN 37604-3698

Phone

(423) 854-9040

Fax

(423) 854-9050

NPI assigned

Apr 22, 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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287446400000",
    "number": "1184680787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1321 SUNSET DR",
            "address_2": "SUITE 22",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043698",
            "telephone_number": "423-854-9040",
            "fax_number": "423-854-9050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 SUNSET DR",
            "address_2": "SUITE 22",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376043698",
            "telephone_number": "423-854-9040",
            "fax_number": "423-854-9050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "PAUL",
        "middle_name": "E",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2010-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TN",
            "license": "MD18878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3033706",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "3119946",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda S Moorhouse, APN
• Shannon Michelle Moorleghen, L.AC.
• Jonathan P Moorman, M.D.
• Sri Pallavi Morampudi, MD
• Breanna Moran
• Ashlyn Nicole Morehouse
• Diana Morelen, PHD
• Ethan Marshall Morelock, PA-C
• Christopher Grant Morgan
• Leah Morgan

• Family Medicine Physician in Johnson City, TN
• Providers in Johnson City, TN by specialty
• Family Medicine Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.