Active NPI
Thomas O'Neal Moore, M.D.
- Public Health & General Preventive Medicine Physician
- Kirtland Afb, NM
National Provider Identifier
1376530964
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 01058273A
- Practice address
- 377 MDG
2050A Second St SE
Kirtland Afb, NM 87117-5522 - Phone
- (505) 846-1186
- NPI assigned
- Sep 29, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician | 2083P0901X | 01058273A | IN | Primary |
Addresses
Primary practice location
377 MDG
2050A Second St SE
Kirtland Afb, NM 87117-5522
Mailing address
377 MDG
2050A Second St SE
Kirtland Afb, NM 87117-5522
Phone (505) 846-1186
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
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01058273A | IN | MD | Public Health & General Preventive Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1251936000000",
"number": "1376530964",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "377 MDG",
"address_2": "2050A SECOND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "505-846-1186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "377 MDG",
"address_2": "2050A SECOND ST SE",
"city": "KIRTLAND AFB",
"state": "NM",
"postal_code": "871175522",
"telephone_number": "505-846-1186"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "THOMAS",
"middle_name": "O'NEAL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-29",
"last_updated": "2009-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "IN",
"license": "01058273A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirtland Afb, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.