NPIMap

Organization Active NPI

Clinical Outcome Improvement Medicine, LLC

  • Internal Medicine Physician
  • Catonsville, MD
National Provider Identifier
1821393919
Registry record updated Jul 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0035330 Issued in MD
Legal business name
CLINICAL OUTCOME IMPROVEMENT MEDICINE, LLC
Practice address
4 E Rolling Crossroads
Suite 102
Catonsville, MD 21228-6210
Phone
(410) 869-3344
Fax
(410) 869-3340
NPI assigned
Jan 20, 2011
Last updated
Jul 15, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2011

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

Authorized official

Name
Dr. Charles E Moore, MDNPI 1275687493
Title
Principal
Phone
(410) 869-3344

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0035330 MD Primary

Addresses

Primary practice location

4 E Rolling Crossroads
Suite 102
Catonsville, MD 21228-6210

Mailing address

PO Box 257
West Friendship, MD 21794-0257
Phone (410) 869-3344

Other names 1

  • CHARLES E MOORE, MD II Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110715000254 MD Part B Supplier - Clinic/Group Practice 1759559859 Receives reassigned benefits from 1 practitioner
Practice locations: Catonsville, MD

National Provider Directory

National Provider Directory

Locations

4 E Rolling Xrds
Ste 102
Catonsville, MD 21228
Phone (410) 274-1689

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1295481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310688000000",
    "number": "1821393919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 257",
            "city": "WEST FRIENDSHIP",
            "state": "MD",
            "postal_code": "217940257",
            "telephone_number": "410-869-3344",
            "fax_number": "410-869-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 E ROLLING CROSSROADS",
            "address_2": "SUITE 102",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286210",
            "telephone_number": "410-869-3344",
            "fax_number": "410-869-3340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL OUTCOME IMPROVEMENT MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-20",
        "last_updated": "2011-07-15",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRINCIPAL",
        "authorized_official_telephone_number": "410-869-3344",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0035330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CHARLES E MOORE, MD II",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.