Active NPI
John Moore Sr.
- Registered Nurse
- Columbus, GA
National Provider Identifier
1487803888
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 179077
- Practice address
- 421 12TH St
Columbus, GA 31901-2522 - Phone
- (706) 494-7776
- Fax
- (706) 494-7076
- NPI assigned
- Sep 10, 2008
- Last updated
- Sep 10, 2008
- 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 |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 179077 | GA | Primary |
Addresses
Primary practice location
421 12TH St
Columbus, GA 31901-2522
Mailing address
9443 Midlandwoods Dr.
Midland, GA 31820
Phone (706) 561-5416
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 179077 | GA | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221004800000",
"number": "1487803888",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9443 MIDLANDWOODS DR.",
"city": "MIDLAND",
"state": "GA",
"postal_code": "31820",
"telephone_number": "706-561-5416"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 12TH ST",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319012522",
"telephone_number": "706-494-7776",
"fax_number": "706-494-7076"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE SR.",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-10",
"last_updated": "2008-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "GA",
"license": "179077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.