Active NPI
George Walter Moore, MD
- Endocrinology, Diabetes & Metabolism Physician
- Bothell, WA
National Provider Identifier
1588604110
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician
- License
- MD00039482
- Practice address
- 1909 214TH Street SE
Suite 211
Bothell, WA 98021 - Phone
- (425) 420-1650
- Fax
- (425) 420-1651
- NPI assigned
- Jun 8, 2006
- 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 |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | MD00039482 | WA | Primary |
Addresses
Primary practice location
1909 214TH Street SE
Suite 211
Bothell, WA 98021
Mailing address
1909 214TH Street SE
Suite 211
Bothell, WA 98021
Phone (425) 420-1650
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0147297 | Other | WA | LABOR AND INDUSTRY |
| 080177572 | Other | WA | RAILROAD MEDICARE |
| MD00039482 | Other | WA | STATE LICENSE NUMBER |
| 8275059 | Medicaid | WA |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | 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 and National Provider Directory roles.
-
dba Frederick Health Hospital
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333497600000",
"number": "1588604110",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1909 214TH STREET SE",
"address_2": "SUITE 211",
"city": "BOTHELL",
"state": "WA",
"postal_code": "98021",
"telephone_number": "425-420-1650",
"fax_number": "425-420-1651"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1909 214TH STREET SE",
"address_2": "SUITE 211",
"city": "BOTHELL",
"state": "WA",
"postal_code": "98021",
"telephone_number": "425-420-1650",
"fax_number": "425-420-1651"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "GEORGE",
"middle_name": "WALTER",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-08",
"last_updated": "2012-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "207RE0101X",
"taxonomy_group": "",
"desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
"state": "WA",
"license": "MD00039482",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR AND INDUSTRY",
"identifier": "0147297",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080177572",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE NUMBER",
"identifier": "MD00039482",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8275059",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bothell, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.