Matthew D Moore LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

35055799M Issued in OH

Legal business name

MATTHEW D MOORE LLC

Practice address

2141 North Fairfield Road
Suite C
Beavercreek, OH 45431-2579

Phone

(937) 429-9683

Fax

(937) 429-9729

NPI assigned

Oct 31, 2007

Last updated

Oct 31, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Matthew D Moore, M.D.NPI 1760593230

Title

Owner

Phone

(937) 429-9683

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew D Moore, MD

  • Family Medicine Physician
  • Beavercreek, OH
  • NPI 1760593230
  NPD (past) Authorized official

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193788800000",
    "number": "1760661367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 NORTH FAIRFIELD ROAD",
            "address_2": "SUITE C",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312579",
            "telephone_number": "937-429-9683",
            "fax_number": "937-429-9729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2141 NORTH FAIRFIELD ROAD",
            "address_2": "SUITE C",
            "city": "BEAVERCREEK",
            "state": "OH",
            "postal_code": "454312579",
            "telephone_number": "937-429-9683",
            "fax_number": "937-429-9729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTHEW D MOORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-429-9683",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35055799M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "2060101",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000281392",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0671983",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Mason, OT
• Timothy Mason, OD
• Judith Marie Masset-Brown, MD
• Rachel Marie Mast, D.O.
• Dale Eugene Mateer, DDS
• Laurel Matthews, MD
• Amanda K Matthias, LISW-S
• Kelsey Mayrand, MD
• Emily Marie Mays, LPCC
• Courtney Anne McCall, MD

• Family Medicine Physician in Beavercreek, OH
• Providers in Beavercreek, OH by specialty
• Family Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; 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.