NPIMap

Organization Active NPI

MD Moore LLC

  • Family Medicine Physician
  • Beattyville, KY
National Provider Identifier
1992422802
Registry record updated Nov 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MD MOORE LLC
Practice address
1031 Hwy 11N
Beattyville, KY 41311
Phone
(606) 595-8454
NPI assigned
Oct 21, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2022

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

Authorized official

Name
Tanya B MooreNPI 1588038129
Title
Owner/Ceo
Phone
(606) 595-8454

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1031 Hwy 11N
Beattyville, KY 41311

Mailing address

1031 Hwy 11N
Beattyville, KY 41311
Phone (606) 595-8454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230214001853 KY Part B Supplier - Clinic/Group Practice 6901278258 Receives reassigned benefits from 5 practitioners
Practice locations: Beattyville, KY

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
M D Moore2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1666310400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669680000000",
    "number": "1992422802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1031 HWY 11N",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "41311",
            "telephone_number": "606-595-8454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 HWY 11N",
            "city": "BEATTYVILLE",
            "state": "KY",
            "postal_code": "41311",
            "telephone_number": "606-595-8454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MD MOORE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-21",
        "last_updated": "2022-11-29",
        "certification_date": "2022-11-29",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "TANYA",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER/CEO",
        "authorized_official_telephone_number": "606-595-8454"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beattyville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.