NPIMap

Individual provider Active NPI

Stephany K Moore, MD

  • Cardiovascular Disease Physician
  • Cambridge, OH
National Provider Identifier
1376529347
Registry record updated Aug 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
35080685 Issued in OH
Practice address
1325 Clark St
Cambridge, OH 43725-9614
Phone
(740) 630-9708
Fax
(740) 630-9709
NPI assigned
Dec 21, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 35080685 OH Primary

Addresses

Primary practice location

1325 Clark St
Cambridge, OH 43725-9614

Mailing address

5400 Frantz Rd
Ste 250
Dublin, OH 43016-6102

Other identifiers 1

IdentifierTypeStateIssuer
2319600MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061025000424 OH Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 0840297313 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
Ohio State University College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians

Practice addresses (Care Compare)

1325 Clark St
Cambridge, OH 43725-9614
Phone (740) 630-9708

Hospital & facility affiliations

  • Southeastern Ohio Regional Medical Center Hospital, Cambridge, OH, CCN 360203
  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • Barnesville Hospital Association, Inc Hospital, Barnesville, OH, CCN 361321
  • Doctors Hospital Hospital, Columbus, OH, CCN 360152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35080685OHMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Sep 25, 2017 Accepting new patients
Ohiohealth Corporation Cardiovascular Disease CurrentSince Sep 25, 2017 Accepting new patients
Cardiology Associates of Southeastern Ohio Inc. PastSince May 1, 2000 Accepting new patients
Genesis Medical Group LLC Cardiovascular Disease Past Accepting new patients
Zanesville Specialists, Inc. Past Accepting new patients

Locations

1341 Clark St
Cambridge, OH 43725
Phone (614) 439-8900

1325 Clark St
Cambridge, OH 43725
Phone (740) 630-9708

Dept L3652
Columbus, OH 43260

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

5400 Frantz Rd
Ste 250
Dublin, OH 43016
Phone (614) 544-6161

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503446400000",
    "number": "1376529347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5400 FRANTZ RD",
            "address_2": "STE 250",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430166102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 CLARK ST",
            "city": "CAMBRIDGE",
            "state": "OH",
            "postal_code": "437259614",
            "telephone_number": "740-630-9708",
            "fax_number": "740-630-9709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STEPHANY",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-21",
        "last_updated": "2017-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "OH",
            "license": "35080685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2319600",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, OH

Sources for this page

Verify at the official NPI Registry.