Evan Corlee Moore, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

7372509-1205 Issued in UT

Practice address

5121 S Cottonwood St
Salt Lake City, UT 84107-5701

Phone

(801) 910-3595

NPI assigned

Apr 20, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in UT

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 1

Specialty

Critical Care (Intensivists)Also: Emergency Medicine

Education

University of Utah School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health McKay-Dee Hospital Hospital, Ogden, UT, CCN 460004

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• Emergency Physicians Integrated Care, LLC

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1578598199
  Medicare reassignment NPD
• Intensive Care Consortium Inc

  • Specialist
  • Aventura, FL
  • NPI 1629019062

  UT

  Medicare reassignment NPD
• Ihc Health Services Inc

  dba McKay Dee Critical Care

  • Critical Care Medicine (Internal Medicine) Physician
  • Ogden, UT
  • NPI 1366764813
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• University of Utah Emergency Physicians

  • Emergency Medical Services (Emergency Medicine) Physician
  • Salt Lake City, UT
  • NPI 1093769218
  NPD (past)
• University of Utah Emergency Physicians

  dba Memorial Hosptial of Sweetwater County

  • Emergency Medicine Physician
  • Rock Springs, WY
  • NPI 1730583295
  NPD (past)

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

• Ihc Health Services Inc

  dba Intermountain Health McKay-Dee Hospital

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1194749580
  Care Compare affiliation

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1205053063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5121 S COTTONWOOD ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841075701",
            "telephone_number": "801-910-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EVAN",
        "middle_name": "CORLEE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-20",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "7372509-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "evan.moore@direct.imail.org",
            "affiliation": "N",
            "address_1": "5121 S Cottonwood St",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841075701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David A Moore, MD
• David Earl Moore, MD
• Davis Scott Moore, PHARMD
• Dean Tyler Moore
• Dominic Moore, M.D.
• Haley Moore
• Hannah Elaine Moore, MD
• Heidi Moore
• Ian Michael Moore
• Jack Moore, MD

• Emergency Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Emergency Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.