Gary Randall Moore, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

01030659A Issued in IN

Practice address

515 Read St
Evansville, IN 47710-1739

Phone

(812) 424-9291

Fax

(812) 421-2722

NPI assigned

May 27, 2005

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1386647972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 READ ST",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477101739",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4011 Gateway Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476308947",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10455 Orthopaedic Dr",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "IN",
            "postal_code": "476307955",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5828 Pearl Dr",
            "address_purpose": "LOCATION",
            "city": "Evansville",
            "state": "IN",
            "postal_code": "477128116",
            "country_code": "US",
            "telephone_number": "812-424-9291",
            "fax_number": "812-421-2722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "GARY",
        "middle_name": "RANDALL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "IN",
            "license": "01030659A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100179870",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000067659",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0231480001",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ann Moore, LSW
• Brandon Mark Moore, DC
• Byron Patrick Moore, D.D.S.
• Charleen M Moore, LCSW
• Edward N Moore, MD
• Gregory W. Moore, MD
• Jacob Clark Moore, DO
• Jeffrey Keith Moore, MD
• Natascha Nikole Moore, MSW
• Sherri Ann Moore, PTA

• Orthopaedic Surgery Physician in Evansville, IN
• Providers in Evansville, IN by specialty
• Orthopaedic Surgery Physician in Indiana

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

Verify at the official NPI Registry.