Individual provider Active NPI

Morgan B. Moore, O.D.

  • Optometrist
  • Burkburnett, TX
National Provider Identifier
1932101441
Registry record updated Dec 31, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2859TG Issued in TX
Practice address
902 W Kramer Rd
Burkburnett, TX 76354-2640
Phone
(940) 569-4131
Fax
(940) 569-4648
NPI assigned
Aug 15, 2005
Last updated
Dec 31, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2859TG TX Primary

Addresses

Primary practice location

902 W Kramer Rd
Burkburnett, TX 76354-2640

Mailing address

902 W Kramer Rd
Burkburnett, TX 76354-2640
Phone (940) 569-4131

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100519000889 TX Practitioner - Optometry 4284763897 Practice locations: Burkburnett, TX

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2895TXMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Clarke Eyecare Center, LLP Optometrist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199059200000",
    "number": "1932101441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W KRAMER RD",
            "city": "BURKBURNETT",
            "state": "TX",
            "postal_code": "763542640",
            "telephone_number": "940-569-4131",
            "fax_number": "940-569-4648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W KRAMER RD",
            "city": "BURKBURNETT",
            "state": "TX",
            "postal_code": "763542640",
            "telephone_number": "940-569-4131",
            "fax_number": "940-569-4648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MORGAN",
        "middle_name": "B.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2007-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2859TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burkburnett, TX

Sources for this page

Verify at the official NPI Registry.