DR. JOHN RUSSELL MOORE (NPI# 1114977550) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114977550 |
| Entity Type | Individual |
| Full Name | DR. JOHN RUSSELL MOORE |
| Credential | M.D. |
| Practice Address |
19001 E 48th St S Independence MO 64055 |
| Practice Telephone | 8168368831 |
| Practice Fax Number | 8167950144 |
| Mailing Telephone | 8168368831 |
| Mailing Fax Number | 8167950144 |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-09-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 2001004851 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 204467005 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851841449 | John Douglas Moore | Military Health Care Provider | 1004 Hermitage Rd Bldg 1014, Virginia Beach, VA 23459-9100 | 2016-10-07 |
| 1790146595 | John Parker Moore | Counselor | 1770 Shiloh Springs Rd., Dayton, OH 45426 | 2016-03-08 |
| 1861815243 | John Steven Moore | Preventive Medicine | 13149 Hill Rd, College Station, TX 77845-9271 | 2014-01-21 |
| 1609218379 | John Easter Moore Jr. | Social Worker | 2032 Sheffield Rd, Oklahoma City, OK 73120-4926 | 2013-07-23 |
| 1972841781 | John A. Moore | Dentist | 113 N. Winter St., Midway, KY 40347-0761 | 2013-01-29 |
| 1487915799 | John S Moore | Registered Nurse | 26300 Ford Rd # 160, Dearborn Heights, MI 48127-2854 | 2012-06-04 |
| 1295028314 | John Robert Moore | Behavioral Analyst | 815 24th St Sw, Vero Beach, FL 32962 | 2011-05-23 |
| 1205130176 | John Robert Moore | Family Medicine | 9715 Hurlbut Rd, Remsen, NY 13438-4621 | 2011-01-06 |
| 1548462385 | John William Moore IIi | Internal Medicine | 2643 Patterson Rd Ste 605, Grand Junction, CO 81506-1937 | 2007-06-04 |
| 1962612317 | John D Moore | Hearing Instrument Specialist | 7050 W Palmetto Park Rd Ste 20, Boca Raton, FL 33433-3462 | 2007-05-23 |
| Street Address |
19001 E 48TH ST S |
| City | INDEPENDENCE |
| State | MO |
| Zip Code | 64055 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336198845 | Harold Calvin Lentz | Urology | 19001 E 48th St S, Independence, MO 64055 | 2006-05-10 |
| 1801389267 | Advanced Urologic Associates, Inc | Physician Assistant | 19001 E 48th St S, Independence, MO 64055-6964 | 2018-06-11 |
| 1093071938 | Advanced Urologic Associates, Inc | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2012-04-04 |
| 1891992228 | Elizabeth Piontek | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2007-06-29 |
| 1083738116 | James Sanford Mcintosh | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2007-03-16 |
| 1679529754 | Midwest Urology & Radiation Oncology, Inc, PC. | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2006-05-26 |
| 1649220088 | Bradley Keith Stanley | Urology | 19001 E 48th St S, Independence, MO 64055 | 2006-05-10 |
| 1720037195 | Robert Juan Biber | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2006-05-10 |
| 1972553378 | David C Lewing | Urology | 19001 E 48th St S, Independence, MO 64055 | 2006-05-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851916035 | Nicholas Portell | Optometrist | 13900 E Us Hwy, Suite A, Independence, MO 64055 | 2020-06-12 |
| 1295396398 | Alyson Forbes | Behavioral Analyst | 4721 S. Cliff Ave, Suite 103, Independence, MO 64055 | 2019-06-28 |
| 1427526458 | Physicians Wellness Group LLC | Family Medicine | 19045 E Valley View Parkway, Suite G, Independence, MO 64055 | 2018-11-07 |
| 1760967707 | Simone Lila Light | Behavioral Analyst | 4721 S. Cliff Ave Suite 103, Suite 103, Independence, MO 64055 | 2018-09-25 |
| 1841786183 | Ladonna Kaye Stephens | Pharmacist | 4100 Bolger Dr, Independence, MO 64055 | 2018-07-10 |
| 1568954873 | Lincare Inc | Durable Medical Equipment & Medical Supplies | 17501 E 40 Hwy Ste 224, Independence, MO 64055 | 2018-06-01 |
| 1710488002 | Zenith Rehabilitation, LLC | Rehabilitation Practitioner | 14500 E 42nd St S Ste 240, Independence, MO 64055 | 2018-02-22 |
| 1720526924 | Ashley & Gray D.d.s.'s | Clinic/Center | 1520 E 23rd Str, Ste Q, Independence, MO 64055 | 2017-02-08 |
| 1942751045 | Mary C Younger | Counselor | 4710 S Cedar Crest Ct Ste 100, Independence, MO 64055 | 2016-10-24 |
| 1497163950 | Carolyn J Wells | Home Health Aide | 13308 E 43rd Terr S, Independence, MO 64055 | 2014-07-29 |
| Find all providers in zip 64055 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205035284 | Ryan Thomas Miller | Urology | 19001 E 48th St. S, Independence, MO 64055 | 2007-07-11 |
| 1336198845 | Harold Calvin Lentz | Urology | 19001 E 48th St S, Independence, MO 64055 | 2006-05-10 |
| 1093071938 | Advanced Urologic Associates, Inc | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2012-04-04 |
| 1245492602 | Andrew B Morris | Urology | 17525 Medical Center Pkwy, Independence, MO 64057-1824 | 2008-06-26 |
| 1891992228 | Elizabeth Piontek | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2007-06-29 |
| 1083738116 | James Sanford Mcintosh | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2007-03-16 |
| 1346260361 | Andrew David Wright | Urology | 17525 Medical Center Pkwy, Independence, MO 64057-1824 | 2006-07-20 |
| 1679529754 | Midwest Urology & Radiation Oncology, Inc, PC. | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2006-05-26 |
| 1649220088 | Bradley Keith Stanley | Urology | 19001 E 48th St S, Independence, MO 64055 | 2006-05-10 |
| 1720037195 | Robert Juan Biber | Urology | 19001 E 48th St S, Independence, MO 64055-6964 | 2006-05-10 |
| Find all providers in INDEPENDENCE | ||||
| City | INDEPENDENCE |
| Zip Code | 64055 |
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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.