Dale G Moore, C.R.N.A.

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

4704186545 Issued in MI

Practice address

125 W Walnut St
Kalamazoo, MI 49007-5239

Phone

(269) 343-1381

Fax

(269) 343-6321

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Registered Nurse

State licenses

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.

• Lakeland Hospitals at Niles and St Joseph, Inc

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  NPD
• Lakeland Hospitals at Niles and St Joseph, Inc

  • Community Health Clinic/Center
  • Saint Joseph, MI
  • NPI 1184513731
  NPD
• Anesthesia Care Associates, LLC

  • Certified Registered Nurse Anesthetist
  • South Bend, IN
  • NPI 1073899449

  Nurse Anesthetist, Certified Registered

  NPD
• Digestive Care of Evansville PC

  • Gastroenterology Physician
  • Newburgh, IN
  • NPI 1376751891
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365465600000",
    "number": "1861436248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 JOHN ST",
            "address_2": "BOX 42",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075341",
            "telephone_number": "269-341-8419",
            "fax_number": "269-341-8743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 W WALNUT ST",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490075239",
            "telephone_number": "269-343-1381",
            "fax_number": "269-343-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DALE",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2013-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704186545",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GRP PIN",
            "identifier": "430C910670",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PIN",
            "identifier": "7450527",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD IND PIN",
            "identifier": "4308757580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Moore
• Andreea Gabriela Moore, MD
• Carrie L Moore, MA, LMSW, CAAC
• Charles Moore, M.D.
• Courtney Christina Moore, BSW
• Dejanique Moore
• Delena Renee Moore
• Emma Jean Moore
• Gwendolyn Layette Moore, RN
• Mary Moore, MA

• Certified Registered Nurse Anesthetist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Certified Registered Nurse Anesthetist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.