Active NPI
John Thomas Moore, PH.D.
- Clinical Psychologist
- Richmond, IN
National Provider Identifier
1679699151
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 20010430A
- Practice address
- 498 NW 18TH St
Richmond, IN 47374-2851 - Phone
- (765) 935-9317
- NPI assigned
- Mar 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 20010430A | IN | Primary |
| Clinical Psychologist | 103TC0700X | 5174 | OH |
Addresses
Primary practice location
498 NW 18TH St
Richmond, IN 47374-2851
Mailing address
507 Rubythroat LN
Clayton, OH 45315-8742
Phone (937) 832-0572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 20010430A | IN | MD | Clinical Psychologist |
| 5174 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1679699151",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "507 RUBYTHROAT LN",
"city": "CLAYTON",
"state": "OH",
"postal_code": "453158742",
"telephone_number": "937-832-0572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "498 NW 18TH ST",
"city": "RICHMOND",
"state": "IN",
"postal_code": "473742851",
"telephone_number": "765-935-9317"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JOHN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "IN",
"license": "20010430A",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "5174",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.