Johnny C. Moreno, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

80-218 Issued in NM

Practice address

606 N 13TH St
Artesia, NM 88210-1165

Phone

(575) 748-1266

Fax

(575) 748-8822

NPI assigned

Jul 13, 2005

Reactivated

Mar 29, 2006

Sex

Male

Sole proprietor

No

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.

• Johnny C. Moreno, MD PA

  • General Practice Physician
  • Artesia, NM
  • NPI 1861421059

  General Practice

  NPD (past) Authorized official
• Artesia General Hospital

  • General Acute Care Hospital
  • Artesia, NM
  • NPI 1437286044
  NPD (past)
• Bulldog Emergency Physicians

  • Emergency Medicine Physician
  • Artesia, NM
  • NPI 1104947191
  NPD (past)
• Yucca Health Care Centers

  • Urgent Care Clinic/Center
  • Artesia, NM
  • NPI 1013143338
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 30, 2011.

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325203200000",
    "number": "1871591701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 N 13TH ST",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101165",
            "telephone_number": "575-748-1266",
            "fax_number": "575-748-8822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N 13TH ST",
            "city": "ARTESIA",
            "state": "NM",
            "postal_code": "882101165",
            "telephone_number": "575-748-1266",
            "fax_number": "575-748-8822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORENO",
        "first_name": "JOHNNY",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2011-12-30",
        "deactivation_date": "2006-03-17",
        "reactivation_date": "2006-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NM",
            "license": "80-218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael J Grafe DO LTD
• Micki J Miller, LMT
• Deserii Mondragon, LMSW
• Alexandra C Moore
• Paola Morales
• Sandra Moreno
• Santiago Chavez Morillon
• David G Morrison, PT
• Dillon Z Moya
• Rene Chavez Moya, DNP

• All providers in Artesia, NM
• General Practice Physician in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2011; 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.