Active NPI
Patrick F Moore, MD
- Family Medicine Physician
- Grand Forks, ND
National Provider Identifier
1265528525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3935
- Practice address
- 1380 S Columbia Rd
Grand Forks, ND 58201-4059 - Phone
- (701) 795-2000
- NPI assigned
- Oct 5, 2006
- Last updated
- Oct 22, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3935 | ND | Primary |
Addresses
Primary practice location
1380 S Columbia Rd
Grand Forks, ND 58201-4059
Mailing address
PO Box 6002
Grand Forks, ND 58206-6002
Phone (701) 780-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1678 | ND | MD | Addiction (Substance Use Disorder) Counselor |
| 3935 | ND | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193011200000",
"number": "1265528525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6002",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582066002",
"telephone_number": "701-780-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 S COLUMBIA RD",
"city": "GRAND FORKS",
"state": "ND",
"postal_code": "582014059",
"telephone_number": "701-795-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "PATRICK",
"middle_name": "F",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2007-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "ND",
"license": "3935",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grand Forks, ND
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.