Individual provider Active NPI

Annette Iola Hollingsworth-Moore, MD

  • Obstetrics & Gynecology Physician
  • Apple Valley, CA
National Provider Identifier
1689827404
Registry record updated Mar 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
A105398 Issued in CA
Practice address
18523 Corwin Rd Ste E
Apple Valley, CA 92307-2300
Phone
(760) 813-3699
Fax
(760) 459-0254
NPI assigned
Oct 23, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X A105398 CA
Obstetrics & Gynecology Physician 207V00000X A105398 CA Primary

Addresses

Primary practice location

18523 Corwin Rd Ste E
Apple Valley, CA 92307-2300

Mailing address

18523 Corwin Rd Ste E
Apple Valley, CA 92307-2300
Phone (760) 813-3699

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A105398CAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anaya Womens OBGYN Group Inc Obstetrics & Gynecology Current Accepting new patients
Primecare Medical Group Past Accepting new patients

Locations

18523 Corwin Rd
Ste E
Apple Valley, CA 92307
Phone (760) 242-1222

18056 Wika Rd
Ste B
Apple Valley, CA 92307
Phone (760) 242-2223

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22125/brand/1/csg/1/fhir/r4

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742515200000",
    "number": "1689827404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18523 CORWIN RD STE E",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072300",
            "telephone_number": "760-813-3699",
            "fax_number": "760-459-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18523 CORWIN RD STE E",
            "city": "APPLE VALLEY",
            "state": "CA",
            "postal_code": "923072300",
            "telephone_number": "760-813-3699",
            "fax_number": "760-459-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLINGSWORTH-MOORE",
        "first_name": "ANNETTE",
        "middle_name": "IOLA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-23",
        "last_updated": "2025-03-21",
        "certification_date": "2025-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "CA",
            "license": "A105398",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "CA",
            "license": "A105398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apple Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2025; 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.