Elizabeth D Moore, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

Practice address

8940 N Wood Sage Road
Peoria, IL 61615

Phone

(309) 243-3000

Fax

(309) 243-3050

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bates Family Diversified, LLC

  • Rural Health Clinic/Center
  • Three Forks, MT
  • NPI 1003466822
  NPD (past)
• Manhattan Medical Services

  • Medical Physician Assistant
  • Manhattan, MT
  • NPI 1225162589
  NPD (past)
• Three Rivers Clinic LLC

  • Rural Health Clinic/Center
  • Three Forks, MT
  • NPI 1851425789
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265543391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-243-3000",
            "fax_number": "309-243-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8940 N WOOD SAGE ROAD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61615",
            "telephone_number": "309-243-3000",
            "fax_number": "309-243-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Rodger Moon, DDS
• Richard T Moon, DDS
• Jonathan William Mooney, PMHNP-BC
• Kari Mooneyham, SLP
• Aimee Moore, PTA
• Evan Moore
• Jamie Lyn Moore, LMT
• Trenadie Moore
• Moose Physical Therapy, PLLC
• Paul Stuart Moots, MD

• Medical Physician Assistant in Peoria, IL
• Providers in Peoria, IL by specialty
• Medical Physician Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.