Active NPI
Gary L Moorman, DO
- Emergency Medicine Physician
- Toledo, OH
National Provider Identifier
1528061231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 34003175
- Practice address
- 2213 Cherry St
Toledo, OH 43608-2603 - Phone
- (419) 251-4204
- NPI assigned
- May 27, 2005
- 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 |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 34003175 | OH | Primary |
Addresses
Primary practice location
2213 Cherry St
Toledo, OH 43608-2603
Mailing address
2942 Shoreland Ave
Toledo, OH 43611-1248
Phone (419) 729-5785
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 114808628 | Medicaid | MI | |
| P00280770 | Other | RAILROAD MEDICARE | |
| 000000377156 | Other | BCBS | |
| 000000360664 | Other | OH | BCBS |
| 114734293 | Medicaid | MI | |
| 0510343 | Medicaid | OH |
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34003175 | OH | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1195084800000",
"number": "1528061231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2942 SHORELAND AVE",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436111248",
"telephone_number": "419-729-5785",
"fax_number": "419-729-4028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2213 CHERRY ST",
"city": "TOLEDO",
"state": "OH",
"postal_code": "436082603",
"telephone_number": "419-251-4204"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORMAN",
"first_name": "GARY",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-27",
"last_updated": "2007-11-15",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "OH",
"license": "34003175",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114808628",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00280770",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000377156",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "000000360664",
"state": "OH"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "114734293",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0510343",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Toledo, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.