Robert L Moore, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18036 Issued in MS

Practice address

5604 Old Canton Rd
Jackson, MS 39211-4217

Phone

(601) 991-1044

Fax

(601) 991-9868

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

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 1

Specialty

Family Practice

Education

University of Mississippi School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Correct Care, Inc.Group PAC ID 8628980992, 96 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Tyler Holmes Memorial Hospital Cah Hospital, Winona, MS, CCN 251312
• Mississippi Baptist Medical Center Hospital, Jackson, MS, CCN 250102

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EGEGCA/Endpoint/EGEGCA

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.

• Moore Healthy Family Medical Clinic, LLC

  • Primary Care Clinic/Center
  • Jackson, MS
  • NPI 1205137304
  Medicare reassignment Authorized official
• Correct Care, Inc.

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1215987441

  MS

  Medicare reassignment Care Compare group

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

• Mississippi Baptist Medical Center, Inc.

  • General Acute Care Hospital
  • Jackson, MS
  • NPI 1710909585
  Care Compare affiliation
• Tyler Holmes Memorial Hospital

  • Critical Access Hospital
  • Winona, MS
  • NPI 1205868627
  Care Compare affiliation

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366243200000",
    "number": "1841281276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5604 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114217",
            "telephone_number": "601-991-1044",
            "fax_number": "601-991-9868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5604 OLD CANTON RD",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392114217",
            "telephone_number": "601-991-1044",
            "fax_number": "601-991-9868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROBERT",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2013-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "18036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04133520",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOL FECA PROVIDER #",
            "identifier": "315954200",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paul H Moore III, M.D.
• Portia Moore
• Rashad J Moore
• Rebecca Suzanne Moore, M.D.
• Robert Keith Moore, R.N.
• Sanetria Moore, CMHT, CCSS
• Shakari Moore
• Shanna Moore, LCSW
• Shannon Monique Moore, PHD
• Steven Patrick Moore, RPT

• Family Medicine Physician in Jackson, MS
• Providers in Jackson, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.