Active NPI
Gerald Clinton Moore, M.D.
- Allergy & Immunology Physician
- Garland, TX
National Provider Identifier
1770531121
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- D9577
- Practice address
- 760 N Shiloh Rd Ste 602
Garland, TX 75042-5714 - Phone
- (972) 272-4463
- Fax
- (972) 272-7137
- NPI assigned
- May 5, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | D9577 | TX | Primary |
Addresses
Primary practice location
760 N Shiloh Rd Ste 602
Garland, TX 75042-5714
Mailing address
PO Box 603725
Charlotte, NC 28260-3725
Phone (828) 575-2625
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 861512 | Other | TX | MEDICARE PTAN |
| 1770531121 | Medicaid | TX | |
| 861510 | Other | TX | MEDICARE PTAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Allergy/Immunology
- Education
- University of Texas Medical School at San Antonio, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
PO Box
Charlotte, NC 28260
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
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": "1699833600000",
"number": "1770531121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 603725",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282603725",
"telephone_number": "828-575-2625",
"fax_number": "828-350-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "760 N SHILOH RD STE 602",
"city": "GARLAND",
"state": "TX",
"postal_code": "750425714",
"telephone_number": "972-272-4463",
"fax_number": "972-272-7137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "GERALD",
"middle_name": "CLINTON",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-05",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "TX",
"license": "D9577",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "861512",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1770531121",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "861510",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Garland, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.