Michael D Moore

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11004975-4405 Issued in UT

Practice address

8846 S Redwood Rd Ste E121
West Jordan, UT 84088-9366

Phone

(801) 569-1999

NPI assigned

May 17, 2024

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

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountainstar Medical Group-St. Marks Hospital LLCGroup PAC ID 1557443322, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Mountainstar Medical Group-St. Marks Hospital, LLC

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1073795258
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1715904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748822400000",
    "number": "1851140149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198560",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8846 S REDWOOD RD STE E121",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840889366",
            "telephone_number": "801-569-1999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-17",
        "last_updated": "2025-06-02",
        "certification_date": "2025-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "11004975-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Montes, M.D.
• Kara Montgomery
• Kelly Montoya
• Krystle Renee Moon
• April Moore
• Peter Steven Moore, DDS
• Brooklyn Moos
• Joseph E Morgan, MD
• Spencer Giles Morgan, MSW LCSW
• Michelle Eva Morholt, FNP-DNP, ARNP-C

• Family Nurse Practitioner in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Family Nurse Practitioner in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2025; 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.