Joseph Reed Moore, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

M-9074 Issued in ID

Practice address

3067 Eagle Dr
Ammon, ID 83406-1273

Phone

(208) 522-4600

Fax

(208) 552-7521

NPI assigned

Sep 8, 2005

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGFGAA

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • NPI 1598383929
  NPD
• Just 4 Kids Pediatrics

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  • NPI 1366560971
  NPD
• Mountain View Hospital LLC

  • General Acute Care Hospital
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  NPD (past)

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1760476469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600",
            "fax_number": "208-552-7521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3067 EAGLE DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834061273",
            "telephone_number": "208-522-4600",
            "fax_number": "208-552-7521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOSEPH",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "ID",
            "license": "M-9074",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "70896",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "000010147395",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806922100",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• April A Moedl, LMSW
• Kimberly Moffat
• Darryl G Moffett Jr., M.D.
• Gary Mondell, RPH
• Bridget Christine Moore, RN
• Whitney Lee Moore, DNP, PMHNP
• Caitlin Morgan, LMSW
• Jocelyn Morgan
• Tucker Mortensen
• Gerald Elbert Mortimer, M.D.

• Pediatrics Physician in Ammon, ID
• Providers in Ammon, ID by specialty
• Pediatrics Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.