Individual provider Active NPI

Edgar Mora, M.D.

  • Internal Medicine Physician
  • Mount Airy, NC
National Provider Identifier
1467483289
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DR.0050568 Issued in CO
Practice address
830 Rockford St
Mount Airy, NC 27030-5322
Phone
(836) 719-7000
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 219050 MA
Internal Medicine Physician 207R00000X DR.0050568 CO Primary

Addresses

Primary practice location

830 Rockford St
Mount Airy, NC 27030-5322

Mailing address

300 Scenic Dr
King, NC 27021-9195

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20120301000635 CO Practitioner - Internal Medicine 7719086438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 E 18TH Ave,
110 Midtown Inpatient Medicine
Denver, CO 80218-1024
Phone (303) 825-4646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
219050MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Services, PC Internal Medicine CurrentSince Jan 10, 2012 Accepting new patients
Inpatient Services, PC Internal Medicine CurrentSince Jan 10, 2012 Accepting new patients
Intermountain Medical Group Denver, LLC Internal Medicine Current Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 5, 2023 Accepting new patients
Intermountain Medical Group Denver, LLC CurrentSince Jul 5, 2023 Accepting new patients
Brighton Community Hospital Association Past Accepting new patients

Locations

835 E 18th Ave
Ste 110
Denver, CO 80218
Phone (303) 825-4646

8300 W 38th Ave
Wheat Ridge, CO 80033
Phone (303) 425-2015

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 and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1467483289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 SCENIC DR",
            "city": "KING",
            "state": "NC",
            "postal_code": "270219195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 ROCKFORD ST",
            "city": "MOUNT AIRY",
            "state": "NC",
            "postal_code": "270305322",
            "telephone_number": "836-719-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORA",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "219050",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CO",
            "license": "DR.0050568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, NC

Sources for this page

Verify at the official NPI Registry.