Justin B Moore, MD

Primary specialty

Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X

License

04-30959 Issued in KS

Practice address

8533 E 32ND St N
Wichita, KS 67226-2611

Phone

(316) 293-2633

Fax

(316) 293-1866

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Great Plains of Cheyenne Co. Inc

  • Critical Access Hospital
  • St Francis, KS
  • NPI 1992736458
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1922133545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1358",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672011358",
            "telephone_number": "316-293-3429",
            "fax_number": "316-293-1882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8533 E 32ND ST N",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672262611",
            "telephone_number": "316-293-2633",
            "fax_number": "316-293-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUSTIN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "04-30959",
            "primary": false
        },
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "KS",
            "license": "04-30959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dennis F Moore Jr., MD
• Elissa Dawn Moore, MS LMFT
• Gary Moore, T-LPC
• Jessica Moore
• Joseph Allen Moore, MD
• Karen A Moore, PT
• Kelly J Moore, LSCSW, LAC
• Kelly Sue Moore, DPT
• Kevin P. Moore, LCMFT
• Kynnedy Janeece Moore

• Endocrinology, Diabetes & Metabolism Physician in Wichita, KS
• Providers in Wichita, KS by specialty
• Endocrinology, Diabetes & Metabolism Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2014; 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.