Christopher Al Moreno, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

M5071 Issued in ID

Practice address

307 St. Johns Way
Suite 11
Lewiston, ID 83501

Phone

(208) 743-7612

Fax

(208) 746-4802

NPI assigned

May 25, 2006

Last updated

Sep 20, 2007By 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 2

Addresses

Other identifiers 8

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Joyce a Majure

  • Surgery Physician
  • Lewiston, ID
  • NPI 1932282431
  NPD (past)

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190246400000",
    "number": "1275589905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 ST. JOHNS WAY",
            "address_2": "SUITE 11",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-743-7612",
            "fax_number": "208-746-4802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 ST. JOHNS WAY",
            "address_2": "SUITE 11",
            "city": "LEWISTON",
            "state": "ID",
            "postal_code": "83501",
            "telephone_number": "208-743-7612",
            "fax_number": "208-746-4802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "CHRISTOPHER",
        "middle_name": "AL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2007-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ID",
            "license": "M5071",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD00024021",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF IDAHO",
            "identifier": "D0782",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1021856",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE/TRI WEST",
            "identifier": "82040040083501A003",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA CRIME VICTIMS PROGRAM",
            "identifier": "8909565",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LABOR & INDUSTRY",
            "identifier": "0096144",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD OF ID",
            "identifier": "000010002753",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002599100",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "020006062",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Neil Mooney, RN
• Julie Moore-Fisher, D.C.
• Amanda Caye Moore, DNP
• Randall R Moore, RPH
• Lois Elizabeth Moree, LMT
• Clinton R Morgan, MD
• John Carl Morgenstern, M.D.
• Wendy Elizabeth Morley, CRNA
• Bradley Jay Morlock, D.D.S.
• Katherine L. Morris, NPC

• Surgery Physician in Lewiston, ID
• Providers in Lewiston, ID by specialty
• Surgery Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.