Active NPI
M B Moore MD Orthopaedic Surgeon PA
- Orthopaedic Surgery Physician
- Mountain Home, AR
National Provider Identifier
1639407323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- M B MOORE MD ORTHOPAEDIC SURGEON PA
- Practice address
- 628 Hospital Dr
Suite E
Mountain Home, AR 72653-2953 - Phone
- (870) 424-4710
- Fax
- (870) 424-4780
- NPI assigned
- Nov 18, 2009
- Last updated
- Jun 25, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Merwin B Moore III, M.D.
- Title
- Owner
- Phone
- (870) 424-4710
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary |
Addresses
Primary practice location
628 Hospital Dr
Suite E
Mountain Home, AR 72653-2953
Mailing address
PO Box 9178
Russellville, AR 72811-9178
Phone (479) 968-4273
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 180094002 | Medicaid | AR | |
| 5G230 | Other | AR | BCBS |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
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.
-
- Orthopaedic Surgery Physician
- Mountain Home, AR
- NPI 1386617561
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1277424000000",
"number": "1639407323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9178",
"city": "RUSSELLVILLE",
"state": "AR",
"postal_code": "728119178",
"telephone_number": "479-968-4273",
"fax_number": "479-968-1363"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "628 HOSPITAL DR",
"address_2": "SUITE E",
"city": "MOUNTAIN HOME",
"state": "AR",
"postal_code": "726532953",
"telephone_number": "870-424-4710",
"fax_number": "870-424-4780"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "M B MOORE MD ORTHOPAEDIC SURGEON PA",
"organizational_subpart": "NO",
"enumeration_date": "2009-11-18",
"last_updated": "2010-06-25",
"status": "A",
"authorized_official_last_name": "MOORE",
"authorized_official_first_name": "MERWIN",
"authorized_official_middle_name": "B",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "870-424-4710",
"authorized_official_name_prefix": "Dr.",
"authorized_official_name_suffix": "III",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "180094002",
"state": "AR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5G230",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mountain Home, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.