Active NPI
Thomas Michael Moran, MD
- Psychiatry Physician
- Saint Louis, MO
National Provider Identifier
1396849485
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 30048
- Practice address
- 889 S Brentwood
Suite 203
Saint Louis, MO 63105 - Phone
- (314) 727-9541
- NPI assigned
- Sep 11, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 30048 | MO | Primary |
Addresses
Primary practice location
889 S Brentwood
Suite 203
Saint Louis, MO 63105
Mailing address
10472 Frontenac Woods LN
Saint Louis, MO 63131
Phone (314) 567-4997
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Dec 30, 2011 through Dec 30, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 30048 | MO | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396849485",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10472 FRONTENAC WOODS LN",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63131",
"telephone_number": "314-567-4997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "889 S BRENTWOOD",
"address_2": "SUITE 203",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "63105",
"telephone_number": "314-727-9541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MORAN",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MO",
"license": "30048",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.