Kimberly Dwan Moore, M.D.

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

4301083522 Issued in MI

Practice address

30055 Northwestern Hwy Ste 270
Farmington Hills, MI 48334-3240

Phone

(248) 865-4220

Fax

(248) 865-4103

NPI assigned

May 3, 2007

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Michigan State University College of Human Medicine, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Henry Ford Semi Medical GroupGroup PAC ID 0648180406, 246 clinicians

Henry Ford Health Providence HospitalGroup PAC ID 6103738703, 364 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Providence Hospital, Southfield and Novi Hospital, Southfield, MI, CCN 230019

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kmoore1142023@direct.hfhs.org

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.

• Henry Ford Health Providence Hospital

  • Surgery Physician
  • Southfield, MI
  • NPI 1942265236

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Henry Ford Semi Medical Group

  • Family Medicine Physician
  • Warren, MI
  • NPI 1942317631

  Obstetrics & Gynecology

  Medicare reassignment Care Compare group NPD
• Henry Ford Health Providence Hospital

  • Pediatrics Physician
  • Southfield, MI
  • NPI 1265497226
  NPD
• Henry Ford Health Providence Hospital

  • Obstetrics & Gynecology Physician
  • Southfield, MI
  • NPI 1912962978
  NPD
• Henry Ford Semi Medical Group

  • Endocrinology, Diabetes & Metabolism Physician
  • Novi, MI
  • NPI 1114133485

  Obstetrics & Gynecology

  NPD
• Ascension Macomb Oakland Hospital

  • Ophthalmology Physician
  • Madison Heights, MI
  • NPI 1114962461
  NPD (past)
• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Henry Ford Health Providence Hospital

  • General Acute Care Hospital
  • Novi, MI
  • NPI 1144210253
  Care Compare affiliation

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1295957926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 270",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343240",
            "telephone_number": "248-865-4220",
            "fax_number": "248-865-4103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30055 NORTHWESTERN HWY STE 270",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483343240",
            "telephone_number": "248-865-4220",
            "fax_number": "248-865-4103"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16001 W 9 Mile Rd",
            "address_purpose": "LOCATION",
            "city": "Southfield",
            "state": "MI",
            "postal_code": "480754818",
            "country_code": "US",
            "telephone_number": "248-849-3140",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KIMBERLY",
        "middle_name": "DWAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "4301083522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kashatria Moore
• Kathryn Moore
• Kayleigh Moore
• Kaytee Moore
• Keira Moore
• Kristavia Moore
• Kyleigh Moore
• Laketia Moore
• Le'Ana Moore
• Louis Moore

• Obstetrics & Gynecology Physician in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Obstetrics & Gynecology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.