William M Moore Jr., MD

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

11908 Issued in SC

Practice address

2728 Sunset Blvd Ste 400
West Columbia, SC 29169-4839

Phone

(803) 936-7095

Fax

(803) 936-7908

NPI assigned

Aug 10, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Lexington Health Inc

  • Sports Medicine (Orthopaedic Surgery) Physician
  • West Columbia, SC
  • NPI 1710634753
  Medicare reassignment NPD
• Lexington Health Inc

  • Cardiovascular Disease Physician
  • West Columbia, SC
  • NPI 1083211312

  Vascular Surgery

  NPD
• Lexington Health Inc

  • Internal Medicine Physician
  • West Columbia, SC
  • NPI 1942190988
  NPD
• Lexington Medical Center

  • General Acute Care Hospital
  • West Columbia, SC
  • NPI 1831550060
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1316958895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6069",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291716069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 400",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694839",
            "telephone_number": "803-936-7095",
            "fax_number": "803-936-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WILLIAM",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "SC",
            "license": "11908",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119080",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00120188",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "wmoore13540@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 400",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brittney Tatiana Moore
• Jessica Moore, LPC
• Norman Blake Moore Jr., CRNA
• Ryan Moore
• Thomas George Moore Jr., CRNA
• Angel T Moorer, RD
• Nannette Morales-Marietti, MD
• Jamel Morant, BS, MA, LMT
• Mark Wafik Morcos, MD
• Ann Bert Morgan, MSN, APRN, BC-FNP

• Vascular Surgery Physician in West Columbia, SC
• Providers in West Columbia, SC by specialty
• Vascular Surgery Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.