Active NPI
Reginald Moore
- Contractor
- Midway, FL
National Provider Identifier
1346893237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Contractor
- License
- JB275890
- Practice address
- 125 Hilltop Dr
Midway, FL 32343-2679 - Phone
- (850) 284-0213
- NPI assigned
- Jul 19, 2019
- Sex
- Male
- Sole proprietor
- Yes
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| JB275890 | FL | MD | Contractor |
Specialties & licenses 1
NPPES NPI Registry| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Contractor | 171W00000X | JB275890 | FL | Primary |
Addresses
NPPES NPI RegistryPrimary practice location
125 Hilltop Dr
Midway, FL 32343-2679
Mailing address
125 Hilltop Dr
Midway, FL 32343-2679
Phone (850) 284-0213
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 19, 2019.
{
"created_epoch": "1563494400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563494400000",
"number": "1346893237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "125 HILLTOP DR",
"city": "MIDWAY",
"state": "FL",
"postal_code": "323432679",
"telephone_number": "850-284-0213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 HILLTOP DR",
"city": "MIDWAY",
"state": "FL",
"postal_code": "323432679",
"telephone_number": "850-284-0213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "REGINALD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-07-19",
"last_updated": "2019-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "171W00000X",
"taxonomy_group": "",
"desc": "Contractor",
"state": "FL",
"license": "JB275890",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midway, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.