Kenneth P Moore, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

KENNETH P MOORE, MD

Doing business as

DBA Ruby Valley Urology

Practice address

1995 Errecart Blvd
Suite 207
Elko, NV 89801-8337

Phone

(775) 738-2218

NPI assigned

Nov 7, 2006

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Page Moore, MDNPI 1700094240

Title

Ceo Ruby Valley Urology

Phone

(775) 738-2218

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• DBA Ruby Valley Urology Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kenneth P Moore, M.D.

  • Urology Physician
  • Del Rio, TX
  • NPI 1700094240
  NPD (past) Authorized official

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1588733349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD",
            "address_2": "SUITE 207",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018337",
            "telephone_number": "775-738-2218",
            "fax_number": "775-738-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1995 ERRECART BLVD",
            "address_2": "SUITE 207",
            "city": "ELKO",
            "state": "NV",
            "postal_code": "898018337",
            "telephone_number": "775-738-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH P MOORE, MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "PAGE",
        "authorized_official_title_or_position": "CEO RUBY VALLEY UROLOGY",
        "authorized_official_telephone_number": "775-738-2218",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100506958",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DBA Ruby Valley Urology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dana C Keaton, APRN
• Jessica Ann Keim, LSW
• Julianne Rebecca Kelly
• Wendy Kemper
• Melissa Kennedy
• Kenneth W Houchin, MD, Dba Elko Eye Center
• Samantha Lynn Kenney
• Amanda Nicole Kerr
• Richard Charles Kidwell, CRNA
• Karen Kimber, CHES

• Urology Physician in Elko, NV
• Providers in Elko, NV by specialty
• Urology Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 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.

Verify at the official NPI Registry.