Organization Active NPI

Moore Hearing Clinic PC

  • Audiologist-Hearing Aid Fitter
  • Ottumwa, IA
National Provider Identifier
1881946572
Registry record updated Dec 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Audiologist-Hearing Aid FitterTaxonomy code 237600000X
License
291, 122 Issued in IA
Legal business name
MOORE HEARING CLINIC PC
Practice address
1317 N Court St
Ottumwa, IA 52501-1911
Phone
(641) 684-7171
Fax
(641) 683-3458
NPI assigned
Oct 5, 2012
Last updated
Dec 17, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2012

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

Authorized official

Name
Gregory Moore, AUDNPI 1700936218
Title
Audiologist
Phone
(641) 683-3277

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist-Hearing Aid Fitter 237600000X 291, 122 IA Primary

Addresses

Primary practice location

1317 N Court St
Ottumwa, IA 52501-1911

Mailing address

1317 N Court St
Ottumwa, IA 52501-1911
Phone (641) 684-7171

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121214000446 IA Part B Supplier - Clinic/Group Practice 6002068277 Receives reassigned benefits from 1 practitioner
Practice locations: Ottumwa, IA

National Provider Directory

National Provider Directory

Locations

1317 North Ct
Ottumwa, IA 52501
Phone (641) 682-4556

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1349395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355702400000",
    "number": "1881946572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1317 N COURT ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525011911",
            "telephone_number": "641-684-7171",
            "fax_number": "641-683-3458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1317 N COURT ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525011911",
            "telephone_number": "641-684-7171",
            "fax_number": "641-683-3458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOORE HEARING CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-05",
        "last_updated": "2012-12-17",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "AUDIOLOGIST",
        "authorized_official_telephone_number": "641-683-3277",
        "authorized_official_credential": "AUD"
    },
    "taxonomies": [
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "IA",
            "license": "291, 122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.