Active NPI
Joseph Carlisle Moore Jr., M.D.
- Pediatrics Physician
- Moncks Corner, SC
National Provider Identifier
1447217385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 9067
- Practice address
- 730 Stoney Landing Rd
Suite 200
Moncks Corner, SC 29461-2948 - Phone
- (843) 761-2000
- Fax
- (843) 761-1388
- NPI assigned
- Apr 26, 2006
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 9067 | SC | Primary |
Addresses
Primary practice location
730 Stoney Landing Rd
Suite 200
Moncks Corner, SC 29461-2948
Mailing address
730 Stoney Landing Rd
Suite 200
Moncks Corner, SC 29461-2948
Phone (843) 761-2000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150127000809 | SC | Order and Referring Only - Pediatric Medicine | 8123342987 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9067 | SC | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1447217385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "730 STONEY LANDING RD",
"address_2": "SUITE 200",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294612948",
"telephone_number": "843-761-2000",
"fax_number": "843-761-1388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "730 STONEY LANDING RD",
"address_2": "SUITE 200",
"city": "MONCKS CORNER",
"state": "SC",
"postal_code": "294612948",
"telephone_number": "843-761-2000",
"fax_number": "843-761-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JOSEPH",
"middle_name": "CARLISLE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "SC",
"license": "9067",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moncks Corner, SC
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.