Active NPI
William Donald Moore, PAC
- Medical Physician Assistant
- Pensacola, FL
National Provider Identifier
1821146838
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA2134
- Practice address
- 1717 N E St
Suite 331
Pensacola, FL 32501-6339 - Phone
- (850) 484-6500
- Fax
- (850) 857-1747
- NPI assigned
- Jan 8, 2007
- 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 |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA2134 | FL | Primary |
Addresses
Primary practice location
1717 N E St
Suite 331
Pensacola, FL 32501-6339
Mailing address
1717 N E St
Suite 331
Pensacola, FL 32501-6339
Phone (850) 484-6500
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 009941519 | Medicaid | AL | |
| 292645800 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA2134 | FL | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Langhorne Cardiology Consultants, Inc. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Interventional Cardiology Physician
- Pensacola, FL
- NPI 1013977941
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168214400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483574400000",
"number": "1821146838",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1717 N E ST",
"address_2": "SUITE 331",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325016339",
"telephone_number": "850-484-6500",
"fax_number": "850-857-1747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 N E ST",
"address_2": "SUITE 331",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325016339",
"telephone_number": "850-484-6500",
"fax_number": "850-857-1747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "WILLIAM",
"middle_name": "DONALD",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-08",
"last_updated": "2017-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "FL",
"license": "PA2134",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "009941519",
"state": "AL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "292645800",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.