Jeffrey Lee Moore, DPM

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

36-00-2397-M Issued in OH

Practice address

135 N Ewing St
Suite 301
Lancaster, OH 43130-3382

Phone

(740) 654-3668

Fax

(740) 654-7528

NPI assigned

Dec 14, 2005

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

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349740800000",
    "number": "1255316915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 N EASTWOOD AVE",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303234",
            "telephone_number": "704-654-5443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 N EWING ST",
            "address_2": "SUITE 301",
            "city": "LANCASTER",
            "state": "OH",
            "postal_code": "431303382",
            "telephone_number": "740-654-3668",
            "fax_number": "740-654-7528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JEFFREY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DPM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2012-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "OH",
            "license": "36-00-2397-M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0654377",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amelia Celeste Moats, DPT
• Joseph A Mong, LPC, CDCA
• Laura Elisabeth Mong, D.O.
• Jason Robert Montgomery, PAC
• Chiemi Lea Moore, R.N.
• Madelyn Moore
• Madelyne Kristen Moore, LSW
• Payton Moore, LSW
• Renee L Moore
• Kaitlyn Moos

• Foot & Ankle Surgery Podiatrist in Lancaster, OH
• Providers in Lancaster, OH by specialty
• Foot & Ankle Surgery Podiatrist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; 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.