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DR. CHARLES S MOORE MD NPI 1902877012


NPI Information

NPI: 1902877012
Provider Name: DR. CHARLES S MOORE, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
20 THE LEGENDS PKWY
EUREKA, MO
ZIP 63025
Phone: (636) 549-0101
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DR. Charles S Moore, MD is a family medicine in Eureka, MO with 21 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Charles S Moore, MD NPI is 1902877012. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: EMORY UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2003

The provider's business location address is:

20 THE LEGENDS PKWY
EUREKA, MO
ZIP 63025-801
Phone: (636) 549-0101
Fax: (636) 549-0101

The NPI 1902877012 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 4/19/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine2013017434MISSOURIYes
2207Q00000XFamily Medicine23555OKLAHOMANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1200045550AMEDICAIDOKLAHOMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.