NPIMap

Organization Active NPI

Richard E Moore Medical PA

  • Anesthesiology Physician
  • Conway, AR
National Provider Identifier
1659737120
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MC-3139 Issued in AR
Legal business name
RICHARD E MOORE MEDICAL PA
Practice address
523 Harkrider St
Conway, AR 72032-5631
Phone
(501) 327-4484
Fax
(501) 327-5963
NPI assigned
Jan 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Mrs. Trysta McGuire
Title
Office Admin
Phone
(501) 733-0311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207L00000X MC-3139 AR Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207LP2900X MC-3139 AR

Addresses

Primary practice location

523 Harkrider St
Conway, AR 72032-5631

Mailing address

523 Harkrider St
Conway, AR 72032-5631
Phone (501) 327-4484

Other identifiers 1

IdentifierTypeStateIssuer
MC-3139OtherARAR STATE MEDICAL BOARD LICENSE NUMBER

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1452643200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1659737120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 HARKRIDER ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325631",
            "telephone_number": "501-327-4484",
            "fax_number": "501-327-5963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 HARKRIDER ST",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720325631",
            "telephone_number": "501-327-4484",
            "fax_number": "501-327-5963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E MOORE MEDICAL PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-13",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "MCGUIRE",
        "authorized_official_first_name": "TRYSTA",
        "authorized_official_title_or_position": "OFFICE ADMIN",
        "authorized_official_telephone_number": "501-733-0311",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology",
            "state": "AR",
            "license": "MC-3139",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "AR",
            "license": "MC-3139",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR STATE MEDICAL BOARD LICENSE NUMBER",
            "identifier": "MC-3139",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conway, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2016; 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.