Active NPI
David Baker Moore, M.D.
- Surgery Physician
- Peachtree City, GA
National Provider Identifier
1851499719
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 27227
- Practice address
- 209 Kelvington Way
Peachtree City, GA 30269-5620 - Phone
- (678) 588-4065
- NPI assigned
- Sep 21, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 27227 | GA | Primary |
Addresses
Primary practice location
209 Kelvington Way
Peachtree City, GA 30269-5620
Mailing address
209 Kelvington Way
Peachtree City, GA 30269-5620
Phone (678) 588-4065
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00350523E | Medicaid | GA |
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
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 027227 | GA | MD | Pharmacist |
| 27227 | GA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585872000000",
"number": "1851499719",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "209 KELVINGTON WAY",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302695620",
"telephone_number": "678-588-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "209 KELVINGTON WAY",
"city": "PEACHTREE CITY",
"state": "GA",
"postal_code": "302695620",
"telephone_number": "678-588-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "DAVID",
"middle_name": "BAKER",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2020-04-03",
"certification_date": "2020-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "GA",
"license": "27227",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00350523E",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Peachtree City, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.