Shawn Christopher Moore, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

655TH 7TH Street
Robins Afb, GA 31098

Phone

(478) 327-8126

NPI assigned

Jul 27, 2009

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1248652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248652800000",
    "number": "1811128754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "128 SINTON PL",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310981045",
            "telephone_number": "478-285-4443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655TH 7TH STREET",
            "city": "ROBINS AFB",
            "state": "GA",
            "postal_code": "31098",
            "telephone_number": "478-327-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHAWN",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-27",
        "last_updated": "2009-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libertad Melendez, O.D.
• Larry Benion Miller, M.S.W.
• Lauren Milligan, LCSW
• Bridget Antoinette Moore, PHARM. D.
• Sean Indiano Moore, M.D.
• Natalia Morales, DMD
• Damon Jamel Murphy, PSY.D.
• Tamara A Murray, D.D.S.
• Charity Rene Naim, LCSW
• National Vision, Inc.

• Independent Duty Medical Technicians in Robins Afb, GA
• Providers in Robins Afb, GA by specialty
• Independent Duty Medical Technicians in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2009; 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.