John Lewis Moore Jr.

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

License

W000-059-784-000 Issued in MN

Practice address

1105 Raymond Ave
Saint Paul, MN 55108-1922

Phone

(651) 706-9918

NPI assigned

Aug 26, 2024

Sex

Male

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1724630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724630400000",
    "number": "1366275281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081922",
            "telephone_number": "651-706-9918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1105 RAYMOND AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081922",
            "telephone_number": "651-706-9918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "LEWIS",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-08-26",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "MN",
            "license": "W000-059-784-000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Moore Family Eyecare PLLC
• Candis Moore
• Courtney Jean Moore, APRN, CNM
• Jason L Moore, M.D.
• Jennifer Moore
• Lanora Moore, RN, LSN
• Steven Robert Moore, M.D.
• Zonita Moore
• Jacob James Mootz, D.C.
• Kristin L Moquist, CPNP

• Non-emergency Medical Transport (VAN) in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Non-emergency Medical Transport (VAN) in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.