Cody Moore

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

112405 Issued in MT

Practice address

600 Mt Highway 91 S
Dillon, MT 59725-7379

Phone

(140) 668-3300

NPI assigned

Mar 18, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Emergency Medicine

Education

University of Washington School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Clark Fork Emergency Physicians PLLCGroup PAC ID 1850491960, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Community Medical Center Hospital, Missoula, MT, CCN 270023
• Barrett Hospital & Healthcare Hospital, Dillon, MT, CCN 271318

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cmoore2457329@wm.providencedirect.org
• Direct secure messaging: cmoore@direct.communitymed.org

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.

• Clark Fork Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Missoula, MT
  • NPI 1538384987
  Medicare reassignment Care Compare group NPD
• Barrett Hospital Development Corporation

  • Critical Access Hospital
  • Dillon, MT
  • NPI 1326042078
  Medicare reassignment NPD
• Barrett Hospital Development Corporation

  • Critical Access Hospital
  • Dillon, MT
  • NPI 1396286480
  Medicare reassignment NPD
• Barrett Hospital Development Corporation

  • Multi-Specialty Clinic/Center
  • Twin Bridges, MT
  • NPI 1265319255
  NPD
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  NPD
• Barrett Hospital Development Corporation

  • Medicare Defined Swing Bed Hospital Unit
  • Dillon, MT
  • NPI 1326419102
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Barrett Hospital Development Corporation

  • Critical Access Hospital
  • Dillon, MT
  • NPI 1326042078
  Care Compare affiliation
• Barrett Hospital Development Corporation

  • Medicare Defined Swing Bed Hospital Unit
  • Dillon, MT
  • NPI 1326419102
  Care Compare affiliation
• RCHP Billings - Missoula LLC

  • General Acute Care Hospital
  • Missoula, MT
  • NPI 1346642899
  Care Compare affiliation

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1720547862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265061200",
            "telephone_number": "304-293-2436",
            "fax_number": "304-293-6702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MT HIGHWAY 91 S",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597257379",
            "telephone_number": "140-668-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265061200",
            "country_code": "US",
            "telephone_number": "304-293-2436",
            "fax_number": "304-293-6702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CODY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MT",
            "license": "112405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoore2457329@wm.providencedirect.org",
            "affiliation": "N",
            "address_1": "600 Mt Highway 91 S",
            "city": "Dillon",
            "state": "MT",
            "country_code": "US",
            "postal_code": "597257379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jennifer Miller, LCPC
• Tracy Lynn Miotke, MT
• Patricia Mitchell, PHARMACIST
• Mitchells Drug Inc
• Montana Migrant and Seasonal Farmworker Council, Inc.
• Gregory J Moore, MD
• Fredrick John Morganthaler II, LCSW
• Christopher Lawrence Murolo, D.C.
• Melinda Sue Newman, LCPC
• Tracy D Nourse, R.N.

• Emergency Medicine Physician in Dillon, MT
• Providers in Dillon, MT by specialty
• Emergency Medicine Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.