Elizabeth Moore, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019031728 Issued in IL

Practice address

141 E Pershing Rd
Decatur, IL 62526-3213

Phone

(888) 988-4066

NPI assigned

Aug 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: elizabeth.mooredmd.p1@direct.chesi.nextgenshare.com

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

{
    "created_epoch": "1534982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534982400000",
    "number": "1891276341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 E ALGONQUIN RD STE 610",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601734166",
            "telephone_number": "888-988-4066",
            "fax_number": "847-496-4850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 E PERSHING RD",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263213",
            "telephone_number": "888-988-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-23",
        "last_updated": "2018-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Moma, MA, CCC-SLP
• Mamatha Moodalagiriaiah, M.D
• Karen Sue Moody, CRNA
• Alyssa G. Moomaw, MS, CCC-SLP/L
• Amanda Moore
• Emma Moore
• Mark J Moore Jr., MD
• Renata Charissa Moore, M.D.
• Terance Moore, PHARMD
• Timothy Howard Moore, L.P.C.

• Dentist in Decatur, IL
• Providers in Decatur, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.