Sandra E Moore, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

051517 Issued in GA

Practice address

777 Hemlock St
MSC 83
Macon, GA 31201-2102

Phone

(478) 633-7140

NPI assigned

Jul 21, 2005

Last updated

Jul 21, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Health Services of Central Georgia, Inc

  dba Atrium Health Navicent Medical Group

  • Multi-Specialty Clinic/Center
  • Macon, GA
  • NPI 1184679482

  Pediatrics

  Medicare reassignment NPD
• Central Georiga Fertility Institute

  • Reproductive Endocrinology Physician
  • Macon, GA
  • NPI 1447390901
  NPD (past)
• Morehouse Healthcare, Inc.

  • Cardiovascular Disease Physician
  • Atlanta, GA
  • NPI 1801832324

  Pediatrics

  NPD (past)
• The Medical Center of Central Georgia Inc

  dba Atrium Health Navicent The Medical Center

  • General Acute Care Hospital
  • Macon, GA
  • NPI 1043270564
  NPD (past)

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1467452375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC 83",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 HEMLOCK ST",
            "address_2": "MSC 83",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312012102",
            "telephone_number": "478-633-7140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SANDRA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2022-07-21",
        "certification_date": "2020-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "051517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keshia Moore, R.N.
• Malcolm S Moore Jr., M.D.
• Marquincio Moore, LPN
• Matthew Benjamin Moore, MD
• Morgan Olivia Moore
• Timothy Tyler Moore
• Vicki Moreno
• Alexandria Morgan, DPT
• Edith Millie Morgan, MSN
• Keath L. Morgan, CRNA

• Pediatrics Physician in Macon, GA
• Providers in Macon, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.

Verify at the official NPI Registry.