Individual provider Active NPI

Aigner Moore, MD

  • Pediatrics Physician
  • Savannah, GA
National Provider Identifier
1720660764
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
100143 Issued in GA
Practice address
3802 Waters Ave
Savannah, GA 31404-6210
Phone
(912) 352-3845
NPI assigned
Apr 28, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X 303308 NC
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 100143 GA Primary

Addresses

Primary practice location

3802 Waters Ave
Savannah, GA 31404-6210

Mailing address

3802 Waters Ave
Savannah, GA 31404-6210
Phone (912) 352-3845

Other practice location 1

301 E Wendover Ave Ste 400
Greensboro, NC 27401-1207
Phone (336) 832-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210623001251 NC Order and Referring Only - Pediatric MedicinePractitioner - Pediatric Medicine 3274934690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
100143GAMDPediatrics Physician
303308NCMDStudent in an Organized Health Care Education/Training Program

Interoperability endpoints

  • Direct secure messaging: aigner.moore.1@23600.direct.athenahealth.com

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1720660764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3802 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046210",
            "telephone_number": "912-352-3845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3802 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046210",
            "telephone_number": "912-352-3845"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "301 E Wendover Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011207",
            "country_code": "US",
            "telephone_number": "336-832-3150",
            "fax_number": "336-832-3152",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AIGNER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-28",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NC",
            "license": "303308",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "100143",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.