Individual provider Active NPI

Andrew Maurice Moore II, M.D.

  • Plastic Surgery Physician
  • Lexington, KY
National Provider Identifier
1295795870
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
22637 Issued in KY
Practice address
1401 Harrodsburg Rd
Suite B488
Lexington, KY 40504-3751
Phone
(859) 276-3883
Fax
(859) 276-3855
NPI assigned
Mar 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 22637 KY Primary

Addresses

Primary practice location

1401 Harrodsburg Rd
Suite B488
Lexington, KY 40504-3751

Mailing address

1401 Harrodsburg Rd
Suite B488
Lexington, KY 40504-3751
Phone (859) 276-3883

Other identifiers 1

IdentifierTypeStateIssuer
64226376MedicaidKY

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

LicenseStateTypeSpecialty
22637KYMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1295795870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "address_2": "SUITE B488",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-276-3883",
            "fax_number": "859-276-3855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 HARRODSBURG RD",
            "address_2": "SUITE B488",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405043751",
            "telephone_number": "859-276-3883",
            "fax_number": "859-276-3855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANDREW",
        "middle_name": "MAURICE",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-27",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "KY",
            "license": "22637",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64226376",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.