Individual provider Active NPI

James Stephen Moore, O.D.

  • Corneal and Contact Management Optometrist
  • McComb, MS
National Provider Identifier
1700834728
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
566 Issued in MS
Practice address
421 Marion Ave
McComb, MS 39648-2709
Phone
(601) 249-0083
Fax
(601) 249-0309
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 566 MS Primary

Addresses

Primary practice location

421 Marion Ave
McComb, MS 39648-2709

Mailing address

421 Marion Ave
McComb, MS 39648-2709
Phone (601) 249-0083

Other identifiers 2

IdentifierTypeStateIssuer
01729377MedicaidMS
5627310001OtherMSMEDICARE DMEPOS SUPPLIER

Other names 1

  • Dr. Steve Moore Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060721000202 MS Practitioner - Optometry 2860405685 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

421 Marion Ave
McComb, MS 39648-2709
Phone (601) 249-0083

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Moore Vision Inc Corneal and Contact Management CurrentSince Jul 6, 2006 Accepting new patients

Locations

421 Marion Ave
McComb, MS 39648
Phone (601) 249-0083

1722 Veterans Blvd
Ste C2
McComb, MS 39648
Phone (601) 249-0083

Organizations & group practices 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1700834728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482709",
            "telephone_number": "601-249-0083",
            "fax_number": "601-249-0309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 MARION AVE",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "396482709",
            "telephone_number": "601-249-0083",
            "fax_number": "601-249-0309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAMES",
        "middle_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2023-03-07",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "MS",
            "license": "566",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01729377",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DMEPOS SUPPLIER",
            "identifier": "5627310001",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEVE",
            "last_name": "MOORE",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in McComb, MS

Sources for this page

Verify at the official NPI Registry.