Patrick Daniel Moore Moore Foot Clinic

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

265 Issued in NE

Legal business name

PATRICK DANIEL MOORE MOORE FOOT CLINIC

Practice address

3811 29TH Ave
Ste 3
Kearney, NE 68845-1280

Phone

(308) 237-2621

Fax

(308) 237-2023

NPI assigned

Oct 24, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Patrick Daniel Moore, DPMNPI 1558321505

Title

Podiatrist.Owner

Phone

(308) 237-2621

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Moore Foot Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Patrick Daniel Moore, DPM

  • Podiatrist
  • Kearney, NE
  • NPI 1558321505

  O20100930059545

  Same enrollment

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Patrick Daniel Moore, DPM

  • Podiatrist
  • Kearney, NE
  • NPI 1558321505
  NPD Authorized official

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

{
    "created_epoch": "1224806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668384000000",
    "number": "1396998134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 29TH AVE",
            "address_2": "STE 3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688451280",
            "telephone_number": "308-237-2621",
            "fax_number": "308-237-2023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 29TH AVE",
            "address_2": "STE 3",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688451280",
            "telephone_number": "308-237-2621",
            "fax_number": "308-237-2023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK DANIEL MOORE MOORE FOOT CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-24",
        "last_updated": "2022-11-14",
        "certification_date": "2022-11-14",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PODIATRIST.OWNER",
        "authorized_official_telephone_number": "308-237-2621",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "NE",
            "license": "265",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1558321505",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moore Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Moore Foot Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Foot & Ankle Surgery Podiatrist in Kearney, NE
• Providers in Kearney, NE by specialty
• Foot & Ankle Surgery Podiatrist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.