NPIMap

Individual provider Active NPI

Richard James Moore, D.O.

  • Family Medicine Physician
  • Bonifay, FL
National Provider Identifier
1902167232
Registry record updated Sep 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS 12696 Issued in FL
Practice address
1702 S Waukesha St
Bonifay, FL 32425-3114
Phone
(850) 547-9991
Fax
(888) 730-6946
NPI assigned
Jun 4, 2012
Last updated
Sep 18, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 18, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X UO 3229 FL
Family Medicine Physician 207Q00000X OS 12696 FL Primary

Addresses

Primary practice location

1702 S Waukesha St
Bonifay, FL 32425-3114

Mailing address

1702 S Waukesha St
Bonifay, FL 32425-3114
Phone (850) 547-9991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150721002162 FL Practitioner - Family Practice 3779896642 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Lake Erie College of Osteopathic Medicine, Erie, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent's Ambulatory Care IncGroup PAC ID 2860411188, 303 clinicians
Contini Family Medicine, LLCGroup PAC ID 6204131709, 4 clinicians

Practice addresses (Care Compare)

1570 Island LN
Fleming Island, FL 32003-7453
Phone (904) 264-1204

3269 Hwy 90
Bonifay, FL 32425-6001
Phone (850) 547-9991

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS 12696FLMDFamily Medicine Physician
UO 3229FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Contini Family Medicine LLC Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 1, 2015 Accepting new patients
St Vincents Ambulatory Care Inc CurrentSince Aug 1, 2015 Accepting new patients
Hannahan Comprehensive Pain Care PC PastSince Sep 21, 2025 Accepting new patients

Locations

1702 S Waukesha St
Bonifay, FL 32425
Phone (850) 547-9991

3269 Highway 90
Bonifay, FL 32425
Phone (850) 547-9991

2627 Riverside Ave
Jacksonville, FL 32204
Phone (904) 308-7372

4205 Belfort Rd
Ste 4020
Jacksonville, FL 32216
Phone (904) 450-6020

1570 Island Ln
Orange Park, FL 32003
Phone (904) 264-1204

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/
  • Direct secure messaging: richard.moore.2@8967.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758153600000",
    "number": "1902167232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1702 S WAUKESHA ST",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324253114",
            "telephone_number": "850-547-9991",
            "fax_number": "888-730-6946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 S WAUKESHA ST",
            "city": "BONIFAY",
            "state": "FL",
            "postal_code": "324253114",
            "telephone_number": "850-547-9991",
            "fax_number": "888-730-6946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "RICHARD",
        "middle_name": "JAMES",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-04",
        "last_updated": "2025-09-18",
        "certification_date": "2025-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "UO 3229",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS 12696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bonifay, FL

Sources for this page

Verify at the official NPI Registry.