NPIMap

Organization Active NPI

Rebecca L. Moore MD Prof Co LTD

  • Hospitalist Physician
  • Craig, CO
National Provider Identifier
1386921658
Registry record updated Jan 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
29536 Issued in CO
Legal business name
REBECCA L. MOORE MD PROF CO LTD
Practice address
750 Hospital Loop
Craig, CO 81625-8750
Phone
(970) 824-9411
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2012

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

Authorized official

Name
Lori A Labrecque
Title
Accounts MGR
Phone
(702) 453-3799

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208M00000X 29536 CO Primary

Addresses

Primary practice location

750 Hospital Loop
Craig, CO 81625-8750

Mailing address

21852 E Ontario Dr
#1427
Aurora, CO 80016-6048
Phone (702) 453-3799

Other identifiers 1

IdentifierTypeStateIssuer
29536OtherCOCO LIC

National Provider Directory

National Provider Directory

Locations

400 S 15th St
#D
Worland, WY 82401
Phone (307) 347-6952

NPI Registry JSON

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

{
    "created_epoch": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327536000000",
    "number": "1386921658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21852 E ONTARIO DR",
            "address_2": "#1427",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800166048",
            "telephone_number": "702-453-3799",
            "fax_number": "702-453-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 HOSPITAL LOOP",
            "city": "CRAIG",
            "state": "CO",
            "postal_code": "816258750",
            "telephone_number": "970-824-9411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REBECCA L. MOORE MD PROF CO LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2012-01-26",
        "status": "A",
        "authorized_official_last_name": "LABRECQUE",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ACCOUNTS MGR",
        "authorized_official_telephone_number": "702-453-3799"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "CO",
            "license": "29536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CO LIC",
            "identifier": "29536",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Craig, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2012; 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.