Laurie Anne Moore, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

118221 Issued in MO

Practice address

126 Missouri Ave
MCXP-CCS-CR
Fort Leonard Wood, MO 65473-8952

Phone

(573) 596-0417

Fax

(573) 596-0524

NPI assigned

Jan 9, 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

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

{
    "created_epoch": "1136764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295713246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 MISSOURI AVE",
            "address_2": "MCXP-CCS-CR",
            "city": "FORT LEONARD WOOD",
            "state": "MO",
            "postal_code": "654738952",
            "telephone_number": "573-596-0417",
            "fax_number": "573-596-0524"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAURIE",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-09",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "118221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Mikaloff
• Marilynn Moehle, CPNP-PC
• Arturo H Montellano, MD
• David Montijo
• Desiree Lenee Moore, D.M.D.
• Mary Sara Moore, PSYCH NP
• Michael Sean Moore, M.D.
• Paige Moreland, MD
• Barbara Ann Morgan
• Timothy Wagner Morgan Jr.

• Physician Assistant in Fort Leonard Wood, MO
• Providers in Fort Leonard Wood, MO by specialty
• Physician Assistant in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.