Kathleen Baker Moore, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD24465 Issued in OR

Practice address

1700 E 19TH St
The Dalles, OR 97058-3317

Phone

(541) 296-1111

NPI assigned

Jun 6, 2006

Sex

Female

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 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kmoore40296@direct.ohsu.edu

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.

• Mid-Columbia Medical Center

  • Rural Health Clinic/Center
  • The Dalles, OR
  • NPI 1154351336
  NPD (past)
• Seattle Emergency Physicians Services Inc PS

  • Emergency Medicine Physician
  • Seattle, WA
  • NPI 1376642298
  NPD (past)

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1200528000000",
    "number": "1396784062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4800",
            "address_2": "UNIT 17",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972084800",
            "telephone_number": "888-633-0087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 E 19TH ST",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583317",
            "telephone_number": "541-296-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KATHLEEN",
        "middle_name": "BAKER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-06",
        "last_updated": "2008-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD24465",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8120099",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA L & I",
            "identifier": "200126",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "227377",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P00242572",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "XPY206683",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA CRIME VICTIMS",
            "identifier": "8906937",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheryl Mojzer
• Shantill Lynn Moody
• Kyle Kathleen Moon
• Paul Oh Sung Moon, M.D.
• Jessica Moore
• Elizabeth A Morales Davila
• Mireya Moreno Ibarra
• Ana Lucia Moreno, M.D.
• Coleen C. Moreno, LCSW, LICSW
• Jason Robert Morich, M.D

• Emergency Medicine Physician in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.