Kevin Lionel St Patrick Moore, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

101 Bodin Cir
SGPF
Travis Afb, CA 94535-1809

Phone

(707) 423-7225

Fax

(707) 423-5026

NPI assigned

May 3, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1241308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241308800000",
    "number": "1649404807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "SGPF",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7225",
            "fax_number": "707-423-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "address_2": "SGPF",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-7225",
            "fax_number": "707-423-5026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEVIN",
        "middle_name": "LIONEL ST PATRICK",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-03",
        "last_updated": "2009-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Royce Molick, D.O.
• Teresa Monteon
• Jorge Montequin, CRNA
• Fredrick Allen Moore Sr., LISW
• Kelley C Moore, CRNA
• Jodie Moraes, APRN
• Cody Ronald Morcom, PHARMD, BCPS
• Miguel Julian Moreno
• Ali Morrell-Balanon, M.D.
• Paulencia Lajoi Morris, D.D.S

• Independent Duty Medical Technicians in Travis Afb, CA
• Providers in Travis Afb, CA by specialty
• Independent Duty Medical Technicians in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2009; 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.