Individual provider Active NPI

James Oliver Moore Jr., MD

  • Family Medicine Physician
  • Zachary, LA
National Provider Identifier
1851711360
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
306768 Issued in LA
Practice address
6300 Main St
Zachary, LA 70791-4037
Phone
(225) 658-4000
NPI assigned
Apr 23, 2014
Last updated
Mar 17, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 306768 LA Primary

Addresses

Primary practice location

6300 Main St
Zachary, LA 70791-4037

Mailing address

1151 Memorial SQ
Zachary, LA 70791-7851
Phone (225) 907-8635

Other practice location 1

811 Elliott Street
Family Medicine
Alexandria, LA 71301
Phone (318) 441-1030 ext. 1

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170822000282 LA Practitioner - Family Practice 4284938853 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
306768LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C & M Medical Services, Inc. CurrentSince Aug 1, 2017 Accepting new patients

Locations

2202 False River Dr
New Roads, LA 70760
Phone (225) 638-5702

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1851711360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 MEMORIAL SQ",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707917851",
            "telephone_number": "225-907-8635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914037",
            "telephone_number": "225-658-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "811 Elliott Street",
            "address_2": "Family Medicine",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "LA",
            "postal_code": "71301",
            "country_code": "US",
            "telephone_number": "318-441-1030 x1",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAMES",
        "middle_name": "OLIVER",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "306768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

Verify at the official NPI Registry.