Charles Henry Moore, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

M4372 Issued in TX

Practice address

2206 E Villa Maria Rd
Bryan, TX 77802-2547

Phone

(979) 776-4600

Fax

(979) 776-8749

NPI assigned

May 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Gastroenterology

Education

University of Arkansas College of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Texas Digestive Disease Association, PAGroup PAC ID 4284618711, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• CHI St Joseph Health Regional Hospital Hospital, Bryan, TX, CCN 450011

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chmoore@yourcarecommunity.org
• Direct secure messaging: centraltexasgi@directaddress.net

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.

• Central Texas Digestive Disease Association, PA

  • Gastroenterology Physician
  • Bryan, TX
  • NPI 1639260763
  Medicare reassignment Care Compare group NPD

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

• St Joseph Regional Health Center

  • General Acute Care Hospital
  • Bryan, TX
  • NPI 1942294939
  Care Compare affiliation
• St. Joseph Regional Health Center

  • General Acute Care Hospital
  • College Station, TX
  • NPI 1053963009
  Care Compare affiliation

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595376000000",
    "number": "1629020011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2206 E VILLA MARIA RD",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022547",
            "telephone_number": "979-776-4600",
            "fax_number": "979-776-8749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHARLES",
        "middle_name": "HENRY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-07-22",
        "certification_date": "2020-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "AR",
            "license": "E-4612",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "M4372",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "centraltexasgi@directaddress.net",
            "affiliation": "N",
            "address_1": "2206 E Villa Maria Rd",
            "city": "Bryan",
            "state": "TX",
            "country_code": "US",
            "postal_code": "778022547",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Wajiha Mohammed, MS
• Gavin P Montalvo, DDS
• Priscilla Lynn Montelongo, LPC
• Eileen Montross, M.D.
• Megan Louise Moonjian, PHARM.D.
• Emily Elizabeth Moore
• Kerry Moore, LPC
• Lee David Moore, M.D.
• David Gabriel Mora-Boellstorff, MD
• Lacie Morace

• Gastroenterology Physician in Bryan, TX
• Providers in Bryan, TX by specialty
• Gastroenterology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.