Tamara Lynn Moore, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD.208034 Issued in LA

Practice address

909 Olive St
Shreveport, LA 71104-2103

Phone

(318) 698-3291

Fax

(318) 698-3293

NPI assigned

Apr 9, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• WK Center for Pediatric Gastroenterology

  • Pediatric Gastroenterology Physician
  • Shreveport, LA
  • NPI 1720620784
  NPD (past)
• WK Pierremont Pediatrics

  • Pediatrics Physician
  • Shreveport, LA
  • NPI 1376745794
  NPD (past)

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

{
    "created_epoch": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656460800000",
    "number": "1497011001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042103",
            "telephone_number": "318-698-3291",
            "fax_number": "318-698-3293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 OLIVE ST",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042103",
            "telephone_number": "318-698-3291",
            "fax_number": "318-698-3293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1501 Kings Hwy",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711034228",
            "country_code": "US",
            "telephone_number": "318-675-8600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TAMARA",
        "middle_name": "LYNN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-09",
        "last_updated": "2022-06-29",
        "certification_date": "2022-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD.208034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2188852",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel Harrison Moore
• Shakisha Moore, LMSW
• Sharon E. Moore, RN
• Shefanie Raychel Moore
• Taffi Moore, PHYSICAL THERAPIST
• Tamara Renese Moore
• Terry Eileen Moore, LPC
• Valentina Moore
• Vivek Moorthy, MD
• Magda Elizabeth Mora Garzon, M.D

• Pediatrics Physician in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.