David G Moore, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

036077697 Issued in IL

Practice address

209 9TH St Ste 200
Rockford, IL 61104

Phone

(779) 696-2750

NPI assigned

Oct 11, 2006

Last updated

Feb 19, 2021By the provider in NPPES

Sex

Male

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613692800000",
    "number": "1538257969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 78866",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532788866",
            "telephone_number": "779-696-7150",
            "fax_number": "779-696-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 9TH ST STE 200",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "61104",
            "telephone_number": "779-696-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DAVID",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2021-02-19",
        "certification_date": "2021-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "IL",
            "license": "036077697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036077697",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmoore911607@direct.uwhealth.org",
            "affiliation": "N",
            "address_1": "209 9th St Ste 200",
            "city": "Rockford",
            "state": "IL",
            "country_code": "US",
            "postal_code": "61104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Matthew Montgomery
• John A Moody, DDS
• Patricia L. Moody, MD
• Alex Moore, DMD, MS
• Burton Emerson Moore
• John Patrick Moore, PA-C
• Kelly James Moore, DDS
• Lily Moore, DPT
• Lindsay Danielle Moore, DMD
• Michelle Moore

• Obstetrics & Gynecology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Obstetrics & Gynecology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2021; 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.