John Michael Moore, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

20795 Issued in KY

Practice address

1401 Harrodsburg Rd Ste B75
Lexington, KY 40504

Phone

(859) 276-3883

Fax

(859) 276-3855

NPI assigned

Mar 27, 2006

Last updated

Aug 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Plastic Surgeons of Lexington, PLLC

  • Plastic Surgery Physician
  • Lexington, KY
  • NPI 1972620151
  Medicare reassignment NPD

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534377600000",
    "number": "1205896826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "address_2": "SUITE B488",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-276-3883",
            "fax_number": "859-276-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD STE B75",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "40504",
            "telephone_number": "859-276-3883",
            "fax_number": "859-276-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2018-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "KY",
            "license": "20795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64207954",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Gene Moore, CSW
• Jacob Aaron Moore, APRN
• James Byron Moore II, DO
• James C. Moore, LCSW
• James Daniel Moore, M.D.
• Kaitlyn Danielle Moore
• Karabeth Moore, MD
• Kelly King Moore, MS, OTR/L
• Kelly N Moore, MSSW, LCSW
• Laura Moore, LPCC

• Plastic Surgery Physician in Lexington, KY
• Providers in Lexington, KY by specialty
• Plastic Surgery Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2018; 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.