NPIMap

Individual provider Active NPI

John William Moore III, MD

  • Clinical Cardiac Electrophysiology Physician
  • Grand Junction, CO
National Provider Identifier
1548462385
Registry record updated Jun 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
DR.0062442 Issued in CO
Practice address
2643 Patterson Rd Ste 605
Grand Junction, CO 81506-1937
Phone
(970) 244-2482
Fax
(970) 255-1701
NPI assigned
Jun 4, 2007
Last updated
Jun 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X DR.0062442 CO
Clinical Cardiac Electrophysiology Physician 207RC0001X DR.0062442 CO Primary

Addresses

Primary practice location

2643 Patterson Rd Ste 605
Grand Junction, CO 81506-1937

Mailing address

2643 Patterson Rd Ste 605
Grand Junction, CO 81506-1937
Phone (970) 244-2482

Other identifiers 1

IdentifierTypeStateIssuer
200422290AMedicaidIN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190702001651 CO Practitioner - Cardiac Electrophysiology 4486731544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac Electrophysiology
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1050 Wellington Ave
Imh Wellington Lung and Sleep Clinic
Grand Junction, CO 81501-8121
Phone (970) 298-5864

201 W Park Dr
201 West Park Cardiology
Grand Junction, CO 81505-1469
Phone (970) 298-3050

2635 N 7TH St
Grand Junction, CO 81501-8209

2686 Patterson Rd
Grand Junction, CO 81506-8817
Phone (970) 298-2001

360 W Park Dr
Intermountain Health Heart and Vascular Wes
Grand Junction, CO 81505-1448
Phone (970) 298-3050

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Intermountain Medical Group Grand Junction, LLC Current Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 13, 2021 Accepting new patients
Intermountain Medical Group Grand Junction, LLC CurrentSince Sep 13, 2021 Accepting new patients
Southside Emergency Associates Past Accepting new patients
Major Hospital Past Accepting new patients
St Mary's Hospital and Medical Center, Inc Past Accepting new patients
St. Francis Medical Group, LLC Past Accepting new patients
Community Medical Group, LLC Past Accepting new patients

Locations

1050 Wellington Ave
Grand Junction, CO 81501
Phone (970) 245-4810

1050 Wellington Ave
Slp Ctr
Grand Junction, CO 81501
Phone (970) 298-5864

201 W Park Dr
Grand Junction, CO 81505
Phone (970) 242-0162

2643 Patterson Rd
Ste 605
Grand Junction, CO 81506
Phone (970) 244-2482

360 W Park Dr
Grand Junction, CO 81505
Phone (970) 244-2482

360 W Park Dr
#1
Grand Junction, CO 81505

Interoperability endpoints

  • Direct secure messaging: tmoore@wsc.gwaydirect.com

Organizations & group practices 8

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559865600000",
    "number": "1548462385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2643 PATTERSON RD STE 605",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061937",
            "telephone_number": "970-244-2482",
            "fax_number": "970-255-1701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2643 PATTERSON RD STE 605",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815061937",
            "telephone_number": "970-244-2482",
            "fax_number": "970-255-1701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-04",
        "last_updated": "2019-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CO",
            "license": "DR.0062442",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "CO",
            "license": "DR.0062442",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200422290A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.