NPIMap

Organization Active NPI

Moore Surgical Assistant, LLC

  • Surgical Assistant
  • Kingston, GA
National Provider Identifier
1679017750
Registry record updated Dec 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical AssistantTaxonomy code 246ZC0007X
Legal business name
MOORE SURGICAL ASSISTANT, LLC
Practice address
80 Moore Rd
Kingston, GA 30145-2619
Phone
(770) 842-1857
Fax
(770) 606-0600
NPI assigned
Dec 8, 2016
Last updated
Dec 8, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2016

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

Authorized official

Name
Vicki L Moore, CST/CSFANPI 1497728406
Title
Preisdent
Phone
(770) 842-1857

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)CodeLicenseStatePrimary
Surgical Assistant 246ZC0007X NU Primary

Addresses

Primary practice location

80 Moore Rd
Kingston, GA 30145-2619

Mailing address

80 Moore Rd
Kingston, GA 30145-2619
Phone (770) 842-1857

National Provider Directory

National Provider Directory

Practitioners & 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.

NPI Registry JSON

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

{
    "created_epoch": "1481155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481155200000",
    "number": "1679017750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MOORE RD",
            "city": "KINGSTON",
            "state": "GA",
            "postal_code": "301452619",
            "telephone_number": "770-842-1857",
            "fax_number": "770-606-0600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MOORE RD",
            "city": "KINGSTON",
            "state": "GA",
            "postal_code": "301452619",
            "telephone_number": "770-842-1857",
            "fax_number": "770-606-0600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE SURGICAL ASSISTANT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-08",
        "last_updated": "2016-12-08",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "VICKI",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PREISDENT",
        "authorized_official_telephone_number": "770-842-1857",
        "authorized_official_credential": "CST/CSFA"
    },
    "taxonomies": [
        {
            "code": "246ZC0007X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Surgical Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 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.