Keith Louis Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA3389 Issued in FL

Practice address

4007 Estate Diamond Ruby
Christiansted, VI 00820-4435

Phone

(340) 778-6311

NPI assigned

Jun 1, 2011

Last updated

Jun 1, 2011By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 VI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Interoperability endpoints

• Direct secure messaging: keith.moore.d1.p1@direct.frederikstedhealthvi.nextgenshare.com

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

{
    "created_epoch": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306886400000",
    "number": "1902190572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1374 MEADOWS BLVD",
            "city": "WESTON",
            "state": "FL",
            "postal_code": "333271804",
            "telephone_number": "954-288-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 ESTATE DIAMOND RUBY",
            "city": "CHRISTIANSTED",
            "state": "VI",
            "postal_code": "008204435",
            "telephone_number": "340-778-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "KEITH",
        "middle_name": "LOUIS",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2011-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MJPT LLC
• Suren K. Mody, M.D., F.R.C.S.
• Kevin Moloney, BCBA
• Jake Edward Monokian, D.C.
• Robert Edward Monokian, D.C.
• Alanna Morales
• Andrea Morgan, PT
• Mary Georgianna Morman, RCS
• Scott Kimberly Morris, PA-C
• Cameron Mosey

• Physician Assistant in Christiansted, VI
• Providers in Christiansted, VI by specialty
• Physician Assistant in U.S. Virgin Islands

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2011; 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.