Evelyn Marie Moore, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.006881 Issued in IL

Practice address

2032 N Prospect Ave
Champaign, IL 61822-1240

Phone

(217) 954-1085

Fax

(217) 607-5457

NPI assigned

Nov 10, 2006

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

State licenses

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.

• America'S Best Contacts & Eyeglasses

  • Optician
  • Champaign, IL
  • NPI 1023411691
  NPD (past)

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1497826655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2032 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221240",
            "telephone_number": "217-954-1085",
            "fax_number": "217-607-5457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2032 N PROSPECT AVE",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618221240",
            "telephone_number": "217-954-1085",
            "fax_number": "217-607-5457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EVELYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-10",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.006881",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001084006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Macey Moody
• David Moon, DDS
• Morgan Leigh Moon, MD, PHD
• Hannah L Mooney, PA
• Moonlight Trauma and Counseling Center PLLC
• Jahnae Moore
• Sam Moore, D.O.
• Eleni Moraites, M.D
• Michael C Moran, MD
• Michael A Moreno, M.D.

• Optometrist in Champaign, IL
• Providers in Champaign, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.