Individual provider Active NPI

Wayne V Moore, MD

  • Pediatric Endocrinology Physician
  • Kansas City, MO
National Provider Identifier
1821045816
Registry record updated Jun 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X
License
MD-201147618 Issued in MO
Practice address
2401 Gillham Rd
Kansas City, MO 64108-4619
Phone
(816) 234-3000
NPI assigned
May 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Endocrinology Physician 2080P0205X MD-201147618 MO Primary

Addresses

Primary practice location

2401 Gillham Rd
Kansas City, MO 64108-4619

Mailing address

2401 Gillham Rd
Kansas City, MO 64108-4619
Phone (816) 234-3000

Other identifiers 1

IdentifierTypeStateIssuer
201147618MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060323000394 KS Practitioner - Pediatric MedicinePractitioner - Endocrinology 6204844814 Reassigns benefits to 3 organizations
I20080530000042 MO Practitioner - EndocrinologyPractitioner - Pediatric Medicine 6204844814 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD-201147618MOMDPediatric Endocrinology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Children'S Mercy Hospital CurrentSince Apr 24, 2015 Accepting new patients
Kansas University Physicians Inc Current Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Jan 18, 2020 Accepting new patients
The Children'S Mercy Hospital CurrentSince Apr 24, 2015 Accepting new patients
Cotton-O'Neil Clinic Revocable Trust CurrentSince Jan 18, 2020 Accepting new patients
The Children'S Mercy Hospital Past Accepting new patients

Locations

3901 Rainbow Blvd
Kansas City, KS 66160
Phone (913) 588-6005

4000 Cambridge St
Kansas City, KS 66160
Phone (913) 588-0000

11300 Corporate Ave
Ste 342
Lenexa, KS 66219
Phone (913) 574-0425

5808 W 110th St
Overland Park, KS 66211
Phone (913) 696-8000

901 SW Garfield Ave
Topeka, KS 66606

1500 SW 10th Ave
Topeka, KS 66604
Phone (785) 354-5242

3520 SW 6th Ave
Topeka, KS 66606
Phone (785) 234-0880

3243 E Murdock St
Wichita, KS 67208
Phone (316) 500-8900

3101 Broadway Blvd
Kansas City, MO 64111
Phone (816) 302-3700

2401 Gillham Rd
Kansas City, MO 64108
Phone (816) 234-3380

Interoperability endpoints

  • Direct secure messaging: wmoore99514@stormontvaildirect.org

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308268800000",
    "number": "1821045816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 GILLHAM RD",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641084619",
            "telephone_number": "816-234-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WAYNE",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-27",
        "last_updated": "2011-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "MO",
            "license": "MD-201147618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201147618",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

Verify at the official NPI Registry.