NICHOLAS MOORE (NPI# 1073875928) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073875928 |
| Entity Type | Individual |
| Full Name | NICHOLAS MOORE |
| Credential | M.D. |
| Practice Address |
1475 Kisker Rd Ste 200 Saint Charles MO 63304-8788 |
| Mailing Address |
Po Box 955534 Saint Louis MO 63195-5534 |
| Practice Telephone | 6364985810 |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-11-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 2012017826 | MO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 615 South New Ballas, Department of Family Medicine, St. Louis, MO 63141 | 3142518950 | 3142518889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265042691 | Nicholas Antonio Moore | Pharmacist | 604 Cherry Dr, Fairview Heights, IL 62208-2846 | 2020-07-31 |
| 1073017679 | Nicholas M Moore | Spec/Tech, Pathology | 1653 W Congress Pkwy Ste 1173, Chicago, IL 60612-3833 | 2018-03-20 |
| 1265727556 | Nicholas Jay Moore | Family Medicine | 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 | 2011-06-14 |
| 1417905092 | Nicholas J.e. Moore | Radiology | 1390 Kelly Johnson Blvd, Colorado Springs, CO 80920-3908 | 2006-05-05 |
| 1093339491 | Nicholas Simms Moore | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Boston, MA 02215-5491 | 2020-06-01 |
| 1396372868 | Nicholas Lawrence Moore | Student in an Organized Health Care Education/Training Program | 111 Colchester Ave, Burlington, VT 05401-1473 | 2020-03-25 |
| 1013550383 | Nicholas Moore | Nurse Anesthetist, Certified Registered | 9333 Imperial Hwy, Downey, CA 90242-2812 | 2019-10-19 |
| 1336795509 | Nicholas M Moore | Psychologist | 1848 Se 1st Ave, Fort Lauderdale, FL 33316-2875 | 2019-08-14 |
| 1225695703 | Nicholas Jay Moore | Dentist | 440 E Tampa St, Springfield, MO 65806-1131 | 2019-05-21 |
| 1467017343 | Nicholas Maximilian Moore | Student in an Organized Health Care Education/Training Program | 1250 E Marshall St, Richmond, VA 23298-5051 | 2019-05-06 |
| Street Address |
1475 KISKER RD STE 200 |
| City | SAINT CHARLES |
| State | MO |
| Zip Code | 63304-8788 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194786434 | Katherine M Dewey | Obstetrics & Gynecology | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304-8788 | 2006-03-28 |
| 1639583073 | Megan Renner | Family Medicine | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304-8788 | 2014-06-13 |
| 1437380276 | Mian Rizwan | Internal Medicine | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304-8788 | 2009-07-28 |
| 1609079409 | Rebecca Ellen Melvin | Internal Medicine | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304 | 2007-06-08 |
| 1477564706 | Rimki Rana | Family Medicine | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304-8788 | 2006-08-11 |
| 1437165834 | Thomas P Gutmann | Internal Medicine | 1475 Kisker Rd Ste 200, Saint Charles, MO 63304-8788 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699382127 | Susan Brockmeyer | Occupational Therapist | 600 Breeze View Ln, Weldon Springs, MO 63304 | 2020-09-29 |
| 1235743097 | Brett Allan Lancaster | Pharmacist | 3801 Old Highway 94, St. Peters, MO 63304 | 2020-08-31 |
| 1356834683 | Emily Elizabeth Blau | Chiropractor | 5055 State Highway N, 108, Cottleville, MO 63304 | 2018-06-12 |
| 1033606769 | Christina Marie Crain | Counselor | 501 Chele Dr, Saint Charles, MO 63304 | 2018-04-18 |
| 1063875532 | Amy L Ney-carder | Speech-Language Pathologist | 5199 State Highway N, St. Peters, MO 63304 | 2016-04-01 |
| 1609127745 | Lawlor Chiropractic LLC | Chiropractor | 6028 Weldon Spring Parkway, Weldon Spring, MO 63304 | 2012-09-28 |
| 1043588510 | Esther Lima | Pharmacist | 3801 S Harvester Rd, St Peters, MO 63304 | 2011-12-12 |
| 1922318245 | Sonya Paramore | Counselor | 1480 Woodstone Drive, Suite 211, Saint Charles, MO 63304 | 2010-10-20 |
| 1871624445 | Joylynn Anderson | Social Worker | 5931 Highway 94 South, Saint Charles, MO 63304 | 2007-03-08 |
| 1821155706 | Cynthia Lynn Sitarski | Occupational Therapist | 4545 Central School Road, St. Charles, MO 63304 | 2007-01-02 |
| Find all providers in zip 63304 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| 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. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669837993 | St. Charles Family Clinic Pllc | Family Medicine | 611 W Belle Avenue, Saint Charles, MI 48655 | 2015-12-31 |
| 1922408426 | Total Access Urgent Care, PC | Family Medicine | 3871 Mexico Rd, Saint Charles, MO 63303-3042 | 2014-09-03 |
| 1154687077 | Elizabeth H Maylack | Family Medicine | 1551 Wall St Ste 400, Saint Charles, MO 63303-3541 | 2012-04-04 |
| 1164793360 | George William Pappas | Family Medicine | 525 Tyler Rd Ste J, Saint Charles, IL 60174-3363 | 2012-01-19 |
| 1407940513 | Hemalini Thakkar | Family Medicine | 2015 Dean St, #2, Saint Charles, IL 60174-1577 | 2006-10-03 |
| 1801903463 | Natan Lvovitch Khotianov | Family Medicine | 12 Tristan Ter, Saint Charles, MO 63303-4207 | 2006-08-23 |
| 1639180631 | Ssm Depaul Medical Group, Inc. | Family Medicine | 1821 Sherman Dr, Saint Charles, MO 63303-3984 | 2006-08-11 |
| 1235173378 | Dr. Eischen Clinic, P. C. | Family Medicine | 106 West Main Street, Suite 267, Saint Charles, IA 50240-0267 | 2006-06-16 |
| 1114977725 | Renato Siazon Lee | Family Medicine | 611 W Belle Ave, Saint Charles, MI 48655-1611 | 2006-05-12 |
| 1013981109 | Steven B Livingstone | Family Medicine | 711 Veterans Memorial Pkwy Ste 300, Saint Charles, MO 63303-2106 | 2006-02-15 |
| Find all providers in SAINT CHARLES | ||||
| City | SAINT CHARLES |
| Zip Code | 63304 |
Please comment or provide details below to improve the information on NICHOLAS MOORE.
| 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.