Active NPI
William M Moore III, M.D.
- Gynecology Physician
- Lyerly, GA
National Provider Identifier
1497851729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Gynecology Physician
- License
- 014534
- Practice address
- 12370 Highway 114
Lyerly, GA 30730-5010 - Phone
- (706) 895-4827
- NPI assigned
- Sep 15, 2006
- Last updated
- Jul 30, 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 |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | 014534 | GA | Primary |
Addresses
Primary practice location
12370 Highway 114
Lyerly, GA 30730-5010
Mailing address
12370 Highway 114
Lyerly, GA 30730-5010
Phone (706) 895-4827
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 014534 | GA | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Roswell Clinic Corp | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Roswell, NM
- NPI 1649267618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1217376000000",
"number": "1497851729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12370 HIGHWAY 114",
"city": "LYERLY",
"state": "GA",
"postal_code": "307305010",
"telephone_number": "706-895-4827"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12370 HIGHWAY 114",
"city": "LYERLY",
"state": "GA",
"postal_code": "307305010",
"telephone_number": "706-895-4827"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "WILLIAM",
"middle_name": "M",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-15",
"last_updated": "2008-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "GA",
"license": "014534",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyerly, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.