Individual provider Active NPI

John H Moore III, M.D.

  • Gastroenterology Physician
  • Mooresville, NC
National Provider Identifier
1760430383
Registry record updated Apr 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
26034 Issued in NC
Practice address
150 Fairview Rd
Suite 120
Mooresville, NC 28117-9504
Phone
(704) 377-4009
NPI assigned
May 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 26034 NC Primary

Addresses

Primary practice location

150 Fairview Rd
Suite 120
Mooresville, NC 28117-9504

Mailing address

PO Box 497
Huntersville, NC 28070-0497
Phone (704) 377-4009

Other identifiers 1

IdentifierTypeStateIssuer
8960293MedicaidNC

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
I20071207000880 NC Practitioner - GastroenterologyPractitioner - Internal Medicine 2062308612 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.22 of 100Reported as group
Quality
100
Promoting interoperability
100
Improvement activities
40
Cost
84.08

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Charlotte Gastroenterology & Hepatology, PLLC Gastroenterology CurrentSince Apr 1, 1998 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC CurrentSince Apr 1, 1998 Accepting new patients
Charlotte Gastroenterology & Hepatology, PLLC Past Accepting new patients

Locations

2015 Randolph Rd
Ste 208
Charlotte, NC 28207
Phone (704) 602-6544

2015 Randolph Rd
Ste 101
Charlotte, NC 28207
Phone (704) 602-6544

4425 Randolph Rd
Ste 105
Charlotte, NC 28211

13808 Professional Center Dr
Huntersville, NC 28078
Phone (704) 717-5549

16525 Holly Crest Ln
Ste 120
Huntersville, NC 28078
Phone (704) 316-5388

150 Fairview Rd
Ste 120
Mooresville, NC 28117
Phone (704) 659-4499

115 Commerce Pointe Blvd
Mooresville, NC 28117
Phone (423) 343-7032

Organizations & group practices 3

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": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1760430383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 497",
            "city": "HUNTERSVILLE",
            "state": "NC",
            "postal_code": "280700497",
            "telephone_number": "704-377-4009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 FAIRVIEW RD",
            "address_2": "SUITE 120",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281179504",
            "telephone_number": "704-377-4009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NC",
            "license": "26034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8960293",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mooresville, NC

Sources for this page

Verify at the official NPI Registry.