NPIMap

Individual provider Active NPI

Joseph Andrew Moore, MD

  • Interventional Cardiology Physician
  • Bolivar, MO
National Provider Identifier
1790719417
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
9600647 Issued in NC
Practice address
1500 N Oakland Ave
Bolivar, MO 65613
Phone
(417) 328-6040
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X ME86388 FL
Interventional Cardiology Physician 207RI0011X 9600647 NC Primary
Interventional Cardiology Physician 207RI0011X 2011007291 MO

Addresses

Primary practice location

1500 N Oakland Ave
Bolivar, MO 65613

Mailing address

800 N Justice St
Box 16
Hendersonville, NC 28791-3410
Phone (828) 694-8350

Other practice location 1

2137 Pardoroyal Dr
Suite 204
Des Peres, MO 63131-1936
Phone (904) 703-2882

Other practice location 2

2026 Wakefield Lake Dr
Glencoe, MO 63038-1210
Phone (904) 703-2882

Other identifiers 4

IdentifierTypeStateIssuer
4458938OtherFLAETNA HMO/PPO
4147194004OtherFLCIGNA
62792OtherFLBCBS
593221727OtherTRICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, NC2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110601000449 MO Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Other (Physician) 8527952803 Reassigns benefits to 1 organization
I20201120002503 NC Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Interventional Cardiology 8527952803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Interventional Cardiology
Education
Medical College of Ohio, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henderson County Hospital CorporationGroup PAC ID 8123938115, 231 clinicians

Practice addresses (Care Compare)

709 N Justice St
Suite a
Hendersonville, NC 28791-3455
Phone (828) 693-8019

Hospital & facility affiliations

  • Pardee Hospital Henderson County Hospital, Hendersonville, NC, CCN 340017
  • Adventhealth Hendersonville Hospital, Hendersonville, NC, CCN 340023
  • Memorial Mission Hospital and Asheville Surgery Ce Hospital, Asheville, NC, CCN 340002
  • Prisma Health Greenville Memorial Hospital Hospital, Greenville, SC, CCN 420078

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting39
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME86388FLMDCardiovascular Disease Physician
2011007291MOMDInterventional Cardiology Physician
9600647NCMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Henderson County Hospital Corporation CurrentSince Jan 1, 2021 Accepting new patients
Citizens Memorial Healthcare CurrentSince Aug 1, 2016 Accepting new patients
Citizens Memorial Healthcare CurrentSince Aug 1, 2016 Accepting new patients
Henderson County Hospital Corporation CurrentSince Jan 1, 2021 Accepting new patients
Florida Physicians & Research Assoc Cardiovascular Disease Past Accepting new patients
St. John'S Mercy Support Services Cardiovascular Disease Past Accepting new patients
St Louis Cardiology Consultants LTD Cardiovascular Disease Past Accepting new patients
SSM Depaul Medical Group, Inc. Past Accepting new patients
Mercy Support Services Past Accepting new patients
Mercy Clinic Cardiovascular and Thoracic Surgery, LLC Past Accepting new patients
Memorial Ekg Associates Past Accepting new patients
Ecg Associates of Jacksonville P a Past Accepting new patients

Locations

1500 N Oakland Ave
Bolivar, MO 65613
Phone (417) 326-6000

2775 Hendersonville Rd
Ste 210
Arden, NC 28704
Phone (828) 435-8280

21 Turtle Creek Dr
Ste 100
Asheville, NC 28803
Phone (828) 435-8394

800 N Justice St
#16
Hendersonville, NC 28791
Phone (828) 694-8350

709 N Justice St
Ste A
Hendersonville, NC 28791
Phone (828) 694-7630

800 N Justice St
Hendersonvlle, NC 28791
Phone (828) 696-1000

Interoperability endpoints

  • Direct secure messaging: jmoore672005@direct.unc.nchie.net

Organizations & group practices 12

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.

Hospital & facility affiliations 43

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 43

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1790719417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 N JUSTICE ST",
            "address_2": "BOX 16",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287913410",
            "telephone_number": "828-694-8350",
            "fax_number": "828-694-7654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N OAKLAND AVE",
            "city": "BOLIVAR",
            "state": "MO",
            "postal_code": "65613",
            "telephone_number": "417-328-6040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2137 Pardoroyal Dr",
            "address_2": "Suite 204",
            "address_purpose": "LOCATION",
            "city": "Des Peres",
            "state": "MO",
            "postal_code": "631311936",
            "country_code": "US",
            "telephone_number": "904-703-2882",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2026 Wakefield Lake Dr",
            "address_purpose": "LOCATION",
            "city": "Glencoe",
            "state": "MO",
            "postal_code": "630381210",
            "country_code": "US",
            "telephone_number": "904-703-2882",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOSEPH",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "FL",
            "license": "ME86388",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "NC",
            "license": "9600647",
            "primary": true
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MO",
            "license": "2011007291",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/PPO",
            "identifier": "4458938",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "4147194004",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "62792",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593221727",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolivar, MO

Sources for this page

Verify at the official NPI Registry.