KEVIN EMMANUAL MOORE (NPI# 1104111590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104111590 |
| Entity Type | Individual |
| Full Name | KEVIN EMMANUAL MOORE |
| Credential | D.P.M. |
| Practice Address |
4660 Riverside Park Blvd Macon GA 31210-1395 |
| Practice Telephone | 4784742114 |
| Mailing Telephone | 4784742114 |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2012-01-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
POD001181 | GA | Podiatric Medicine & Surgery Service Providers |
| N | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
288 | OK | Podiatric Medicine & Surgery Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154781060 | Kevin Lee Moore | Internal Medicine | 612 Nw 42nd St, Oklahoma City, OK 73118-7004 | 2016-03-04 |
| 1932516788 | Kevin Duane Moore | Licensed Practical Nurse | 121 Swezey Ln, Middle Island, NY 11953-1547 | 2014-07-14 |
| 1982947164 | Kevin Moore | Counselor | 107 Hill St, Apt. 9, Stoneham, MA 02180-3720 | 2013-04-05 |
| 1891917324 | Kevin P. Moore | Marriage & Family Therapist | 7200 W 13th St N Ste 9, Wichita, KS 67212-2968 | 2007-05-03 |
| 1255484036 | Kevin Brian Moore | Chiropractor | 1004 Butler Ave, New Castle, PA 16101-4282 | 2007-01-18 |
| 1275690323 | Kevin Lee Moore | Dentist | 160 S 2nd Ave, Suite B, Clarion, PA 16214-2444 | 2007-01-01 |
| 1225199706 | Kevin Brent Moore | Dentist | 95 Stonecoal Road, Garrett, KY 41630 | 2006-12-12 |
| 1447319645 | Kevin Moore | Counselor | 314 Maxwell Rd Ste 400, Alpharetta, GA 30004-2045 | 2006-12-06 |
| 1619040037 | Kevin R Moore | Case Manager/Care Coordinator | 10528 Nw 57th Ct, Coral Springs, FL 33076-2810 | 2006-11-15 |
| 1023069176 | Kevin Joel Moore | Chiropractor | 3420 Elmore Ave, Davenport, IA 52807-2594 | 2006-05-13 |
| Street Address |
4660 RIVERSIDE PARK BLVD |
| City | MACON |
| State | GA |
| Zip Code | 31210-1395 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528038635 | Middle Georgia Anesthesiology Services Inc. | Nurse Anesthetist, Certified Registered | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2006-01-23 |
| 1699327791 | Maria Hicks Carter | Nurse Practitioner | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2019-07-10 |
| 1235791146 | Jessi Lalena Hammond | Nurse Practitioner | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2019-07-01 |
| 1417412032 | Shae Horsting Stephens | Nurse Practitioner | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2019-02-07 |
| 1558883637 | Christina Ashley Peppers | Nurse Practitioner | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2017-07-11 |
| 1811397037 | Rebecca Ewing | Specialist/Technologist | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2014-08-25 |
| 1013134816 | Joseph Sam Hadaway | Specialist/Technologist | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2007-04-20 |
| 1013134824 | The Athletic Therapy & Rehab Institute (atari) | Specialist/Technologist | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2007-04-20 |
| 1679790844 | Frank Heath Mills | Specialist/Technologist | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2007-04-19 |
| 1467679621 | Brian J. Ross | Physical Therapist | 4660 Riverside Park Blvd, Macon, GA 31210-1395 | 2007-04-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033743455 | Dana Elizabeth Toth | Nurse Practitioner | 5300 Bowman Rd, Macon, GA 31210 | 2020-02-25 |
| 1871124735 | Jessica Bello | Nurse Practitioner | 5300 Bowman Road, Macon, GA 31210 | 2020-01-30 |
| 1225505787 | Rebekah Hollinshead | Occupational Therapist | Therapy Specialists of Georgia, 4116 Arkwright Road, Macon, GA 31210 | 2018-11-01 |
| 1346744943 | Ace Medical Transport LLC. | Ambulance | 728 Gay Dr, Macon, GA 31210 | 2018-03-20 |
| 1972965226 | Omar Faruk Ahmad | Family Medicine | 3400 Riverside Drvie, Macon, GA 31210 | 2016-03-25 |
| 1083074868 | Macon Dentist Office, PC | Dentist | 206 Tom Hill Sr Blvd, Suite 106, Macon, GA 31210 | 2016-03-07 |
| 1992176952 | Kerisia Wasztyl | Marriage & Family Therapist | 4691 Pine Valley Dr, Macon, GA 31210 | 2015-10-15 |
| 1073905444 | Eunice Malave De Leon | Social Worker | 174 Spring St, Macon, GA 31210 | 2015-02-23 |
| 1396141545 | Axis Surgery Center LLC | Clinic/Center | 230 Sheraton Blvd, Ste B, Macon, GA 31210 | 2014-11-17 |
| 1073914115 | Monique Rechelle Delay Moore | Community/Behavioral Health | 646 Millrun Court, Macon, GA 31210 | 2014-09-09 |
| Find all providers in zip 31210 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649648569 | Feet First Podiatry, LLC | Podiatrist | 440 Charter Blvd Ste 2202, Macon, GA 31210-0705 | 2015-09-09 |
| 1336310341 | Family Foot Clinic LLC | Podiatrist | 106 Butler St Ste A, Macon, MO 63552-1629 | 2008-03-18 |
| 1023563210 | Moore Foot and Ankle Solutions, LLC | Podiatrist | 4100 Riverside Dr Ste 97, Macon, GA 31210-1848 | 2016-08-17 |
| 1730375536 | Foot & Leg Centers of America | Podiatrist | 3556 Riverside Dr, Macon, GA 31210-2509 | 2007-09-15 |
| 1740322700 | Foot and Leg Centers of Georgia | Podiatrist | 3556 Riverside Dr, Macon, GA 31210-2509 | 2007-02-13 |
| 1124036934 | Ge Ye | Podiatrist | 2180 Vineville Ave, Macon, GA 31204-3124 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518515980 | Da Vinci Foot and Ankle Madison LLC | Podiatrist | 1740 Lions Club Rd Ste 200, Madison, GA 30650-4762 | 2019-08-29 |
| 1376191106 | Ryan Goldfine Dpm LLC | Podiatrist | 3451 Ernest W Barrett Pkwy Suite 170, Mariettta, GA 30269 | 2019-08-26 |
| 1073076170 | Kalish Foot & Ankle Institute | Podiatrist | 6911 Tara Blvd Ste 101, Jonesboro, GA 30236-1503 | 2019-04-08 |
| 1427523919 | Tommy Lee Tally | Podiatrist | 8225 Mall Pkwy Ste 230, Lithonia, GA 30038-6913 | 2018-10-10 |
| 1881188944 | Joshua Jae Lee | Podiatrist | 3425 Buford Dr Ste 350, Buford, GA 30519-8785 | 2018-06-21 |
| 1437652815 | Southeast Regional Primary Care Corporation | Podiatrist | 1707 Meadows Ln Ste H, Vidalia, GA 30474-7201 | 2018-03-13 |
| 1447762927 | Ponders Podiatry LLC | Podiatrist | 275 Carpenter Drive Ne, Suite 106, Atlanta, GA 30328 | 2017-10-24 |
| 1194245894 | Yusuf Abiodun Opakunle | Podiatrist | 600 Professional Dr Ste 130, Lawrenceville, GA 30046-7638 | 2017-06-23 |
| 1891228540 | Vishal Patel | Podiatrist | 755 Mount Vernon Hwy Ne Ste 210, Atlanta, GA 30328-4279 | 2017-04-10 |
| 1497296552 | Ankle and Foot Assoc, LLC | Podiatrist | 118 Azalea Rd, Suite 1-2, Baxley, GA 31513-0672 | 2017-03-09 |
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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.