Individual provider Active NPI

Laura L Moore, M.D.

  • Internal Medicine Physician
  • Klamath Falls, OR
National Provider Identifier
1396793287
Registry record updated Oct 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD15763 Issued in OR
Practice address
3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982
Phone
(541) 883-2337
Fax
(541) 883-2504
NPI assigned
May 4, 2006
Last updated
Oct 26, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD15763 OR Primary

Addresses

Primary practice location

3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982

Mailing address

3737 Shasta Way Ste a
Klamath Falls, OR 97603-4982
Phone (541) 883-2337

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120607000744 OR Practitioner - Emergency Medicine 9537179874 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Oregon Health Sciences University School of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northwest Medical Homes, LLCGroup PAC ID 0042100372, 31 clinicians

Practice addresses (Care Compare)

2280 Marcola Rd
Springfield, OR 97477-2594
Phone (541) 747-4300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northwest Medical Homes, LLC CurrentSince Oct 1, 2023 Accepting new patients
Northwest Medical Homes, LLC Current Accepting new patients
Northwest Medical Homes, LLC CurrentSince Oct 1, 2023 Accepting new patients
Icco, LLC Current Accepting new patients
Icco, LLC CurrentSince Mar 10, 2020 Accepting new patients
Icco LLC CurrentSince Mar 10, 2020 Accepting new patients

Locations

598 E 13th Ave
Eugene, OR 97401
Phone (541) 636-3473

3737 Shasta Way
Ste A
Klamath Falls, OR 97603
Phone (541) 883-2337

1800 Centennial Blvd
Springfield, OR 97477
Phone (541) 747-4300

2280 Marcola Rd
Springfield, OR 97477
Phone (541) 747-4300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BEGCAA
  • Direct secure messaging: laura.moore.basinimmediatecare@jhie.net

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288051200000",
    "number": "1396793287",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY STE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034982",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3737 SHASTA WAY STE A",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976034982",
            "telephone_number": "541-883-2337",
            "fax_number": "541-883-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAURA",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2010-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD15763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Klamath Falls, OR

Sources for this page

Verify at the official NPI Registry.