NPIMap

Organization Active NPI

Moore OBGYN LLC

  • Obstetrics & Gynecology Physician
  • Upper Marlboro, MD
National Provider Identifier
1720973308
Registry record updated Jun 12, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MOORE OBGYN LLC
Practice address
1300 Caraway CT Ste 103
Upper Marlboro, MD 20774-5462
Phone
(301) 669-1870
Fax
(301) 669-1873
NPI assigned
Jun 12, 2025
Organization subpart
Yes
Parent organization
MOORE OBGYN LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 12, 2025

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

Authorized official

Name
Brooke Henderson
Title
Practice Admin/Credentialing
Phone
(301) 669-1870

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

1300 Caraway CT Ste 103
Upper Marlboro, MD 20774-5462

Mailing address

7610 Pennsylvania Ave Ste 305
Forestville, MD 20747-4764
Phone (301) 669-1870

National Provider Directory

National Provider Directory
Tax ID family
Moore OBGYN LLC7 organizations share this tax ID, including this one
Part of
Moore OBGYN LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749686400000",
    "number": "1720973308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7610 PENNSYLVANIA AVE STE 305",
            "city": "FORESTVILLE",
            "state": "MD",
            "postal_code": "207474764",
            "telephone_number": "301-669-1870",
            "fax_number": "301-669-1873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 CARAWAY CT STE 103",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207745462",
            "telephone_number": "301-669-1870",
            "fax_number": "301-669-1873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE OBGYN LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOORE OBGYN LLC",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-06-12",
        "certification_date": "2025-06-12",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_title_or_position": "PRACTICE ADMIN/CREDENTIALING",
        "authorized_official_telephone_number": "301-669-1870"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 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.