VICKI DARLENE MOORE (NPI# 1023193745) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023193745 |
| Entity Type | Individual |
| Full Name | VICKI DARLENE MOORE |
| Credential | RN, MSN, ACNP |
| Practice Address |
3181 Sw Sam Jackson Park Rd Portland OR 97239-3011 |
| Practice Telephone | 5034947481 |
| Practice Fax Number | 5034940822 |
| Mailing Telephone | 5034947481 |
| Mailing Fax Number | 5034940822 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-01-13 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
201809959NPPP | OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE PTAN | CA122795 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023280039 | Vicki P Moore | Pediatrics | 1451 Brush Creek Rd, Prosper, TX 75078-7057 | 2008-03-31 |
| 1790989085 | Vicki J Moore | Massage Therapist | 199 Nw Deer St, Prineville, OR 97754-1701 | 2007-06-12 |
| 1609978519 | Vicki Anne Moore | Anesthesiology | 2050 Race St, Denver, CO 80205-5636 | 2006-09-01 |
| 1497728406 | Vicki Lynn Moore | Specialist/Technologist, Other | 1409 Dunwoody Place, Atlanta, GA 30350 | 2006-02-09 |
| 1649709809 | Vicki C Moore | Social Worker | 1565 Sainte Genevieve Ave, Farmington, MO 63640-3454 | 2017-06-09 |
| 1275086977 | Vicki Moore | Nurse Practitioner | 5929 Timber Ridge Dr, Prospect, KY 40059-8132 | 2016-07-28 |
| 1700177151 | Vicki M Moore | Dietitian, Registered | 301 Yadkin St, Albemarle, NC 28001-3441 | 2011-04-20 |
| 1942349220 | Vicki L Moore | Family Medicine | 7191 Cahaba Valley Rd, Suite 300, Birmingham, AL 35242-6402 | 2007-02-05 |
| 1215020920 | Vicki Hurley Moore | Nurse Practitioner | 500 S Mount Olive St, Suite 200, Siloam Springs, AR 72761-3602 | 2006-10-02 |
| Street Address |
3181 SW SAM JACKSON PARK RD |
| City | PORTLAND |
| State | OR |
| Zip Code | 97239-3011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972506301 | Jerris Robert Hedges | Emergency Medicine | 3181 Sw Sam Jackson Park Rd, # L-102, Portland, OR 97239-3011 | 2005-05-31 |
| 1114528486 | Nathan Stencel | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-11-04 |
| 1073113064 | Evan Mitchell | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-28 |
| 1629678834 | Vanessa Davie | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-27 |
| 1952901480 | Jackie Kim Sharpe | Pharmacist | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-26 |
| 1922607530 | Leah Snyder | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-23 |
| 1932708740 | Blake Beneville | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3098 | 2020-10-22 |
| 1154920833 | Isabelle Nguyen | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-22 |
| 1124627054 | Musah N Iddrisu | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-21 |
| 1386242105 | Wenelia Baghoomian | Student in an Organized Health Care Education/Training Program | 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 | 2020-10-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558979468 | Elise Caitlin Esposito | Student in an Organized Health Care Education/Training Program | 3710 Sw U.S. Veterans Hospital Road, Dental Service P-3 Dent, Attn: Elise Esposito, Portland, OR 97239 | 2020-07-16 |
| 1750908844 | Will Cowan | Student in an Organized Health Care Education/Training Program | 455 Sw Us Veterans Hospital Road., Portland, OR 97239 | 2020-07-06 |
| 1881219657 | Desiree Baer | Licensed Vocational Nurse | Sw Us Veterans Hospital Rd, Portland, OR 97239 | 2020-06-08 |
| 1285266205 | Melissa Irene Wheeler | Registered Nurse | Uhs-8l, 3181 S.w. Sam Jackson Park Road, Portland, OR 97239 | 2020-02-07 |
| 1225687981 | Pheba Mariam Jones | Pharmacist | Ohsu Pharmacy At Chh Building 2, 3303 Sw Bond Ave Rm 1090, Portland, OR 97239 | 2019-09-05 |
| 1801448063 | Alice Huang Huang | Student in an Organized Health Care Education/Training Program | 3710 Sw Veterans Road, Portland, OR 97239 | 2019-07-09 |
| 1710446273 | Ellen Noreen Kessi | Social Worker | 3710 Sw Us Veterans Rd., Portland, OR 97239 | 2019-03-14 |
| 1508335704 | Jacqueline Marie Mular | Marriage & Family Therapist | 5550 Sw Macadam Suite 100, Portland, OR 97239 | 2018-11-16 |
| 1275030926 | Carly Elizabeth Dougher | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239 | 2018-04-10 |
| 1780188094 | Dennis John Samuel | Student in an Organized Health Care Education/Training Program | Ohsu, 3181 Sw Sam Jackson Park Rd. L-579, Portland, OR 97239 | 2018-03-21 |
| Find all providers in zip 97239 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588136295 | Tao Wang | Nurse Practitioner | 38 Michele Dr, Portland, CT 06480-1013 | 2018-12-19 |
| 1679041115 | Kendra Kathryn Mundstock | Nurse Practitioner | 3181 Sw Sam Jackson Park Rd # 13k, Portland, OR 97239-3011 | 2018-11-02 |
| 1043786551 | Lindsey Forleo | Nurse Practitioner | 22 Bramhall St Rm 4670, Portland, ME 04102-3134 | 2018-10-23 |
| 1659801785 | Christine Haboush | Nurse Practitioner | 6015 Ne Skidmore St, Portland, OR 97218-2225 | 2017-06-12 |
| 1386042315 | Jessica Mayer | Nurse Practitioner | 122 Se 80th Ave, Portland, OR 97215-1522 | 2014-12-08 |
| 1376814095 | Paula Claire Havelin | Nurse Practitioner | 235 Highway 52 W, Portland, TN 37148-1407 | 2012-01-26 |
| 1417284175 | Derek Neil Bowers | Nurse Practitioner | 2836 Ne Bryce St, Portland, OR 97212-1640 | 2009-11-17 |
| 1982820692 | Hilary Anne Shreves | Nurse Practitioner | 3303 Sw Bond Ave Ste 10, Portland, OR 97239-4501 | 2007-04-18 |
| 1588691117 | Emily Tidwell | Nurse Practitioner | 421 N Broadway, Portland, TN 37148-1750 | 2006-06-27 |
| 1639174287 | Dawn F. Tilgner | Nurse Practitioner | 3303 Sw Bond Ave, Portland, OR 97239-4501 | 2005-06-19 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.