DOROTHY D MOORE (NPI# 1164567996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164567996 |
| Entity Type | Individual |
| Full Name | DOROTHY D MOORE |
| Other Name | DOROTHY DICKSON |
| Credential | FNP |
| Practice Address |
415 South 28th Avenue Hattiesburg MS 39401 |
| Practice Telephone | 6015795430 |
| Practice Fax Number | 6012685819 |
| Mailing Telephone | 6015795430 |
| Mailing Fax Number | 6015795240 |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-07-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
R638412 | MS | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | UNITED HEALTHCARE | 2879805 | 01 |
| MS | AETNA | 9914083 | 01 |
| MS | 07822378 | 05 | |
| MS | CIGNA | 4875174 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124662531 | Dorothy M Moore | Homemaker | 2211 Highway 45 N Ste G2211, Meridian, MS 39301-2730 | 2019-10-30 |
| 1871014530 | Dorothy James Moore | Nurse Practitioner | 583 Silverado Dr, Lafayette, CA 94549-5547 | 2017-07-03 |
| 1578989059 | Dorothy Gwen Moore | Family Medicine | 626 N Paulina Ave, Redondo Beach, CA 90277-3022 | 2014-03-09 |
| 1700213766 | Dorothy M Moore | Counselor | 1352 Keaton Way, Chesapeake, VA 23321-3100 | 2013-10-03 |
| 1184933350 | Dorothy Moore | Counselor | 20020 Hwy 35, Alvin, TX 77511 | 2010-10-05 |
| 1689891541 | Dorothy J Moore | Chiropractor | 4700 Highway 365, Suite D, Port Arthur, TX 77642-7718 | 2007-04-19 |
| 1639712631 | Dorothy Ann Moore | Physical Therapist | 1700 Pine St, Norristown, PA 19401-3040 | 2019-10-22 |
| 1285005983 | Dorothy Moore | Family Medicine | 2304 W Michigan Ave, Midland, TX 79701-5830 | 2015-10-08 |
| 1003177528 | Dorothy Moore | Home Health Aide | 5101 Wisconsin Ave Nw, 250, Washington, DC 20016-4120 | 2012-05-31 |
| 1225167836 | Dorothy Virginia Moore | Social Worker | 11161 New Hampshire Ave, Suite 307, Silver Spring, MD 20904-2606 | 2007-03-02 |
| Street Address |
415 SOUTH 28TH AVENUE |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235139866 | Santo M Borganelli | Internal Medicine | 415 South 28th Avenue, Hattiesburg, MS 39401 | 2005-07-26 |
| 1710997077 | Sean Douglas Fink | Internal Medicine | 415 South 28th Avenue, Hattiesburg, MS 39401-7246 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588278618 | Joshua Cole Hammons | Nurse Practitioner | 2134 Weeping Willow Cir, Hattiesburg, MS 39402-6096 | 2020-09-05 |
| 1518571900 | Lawanda Nicole Ellis | Nurse Practitioner | 4124 W 4th St Apt 2010, Hattiesburg, MS 39401-5791 | 2020-09-02 |
| 1851913768 | Maryam Rahmanian | Nurse Practitioner | 27 Lake Forgetful Apt 815, Hattiesburg, MS 39402-8288 | 2020-05-13 |
| 1477188332 | Stacy Williams | Nurse Practitioner | 18 Nicolaus Dr, Hattiesburg, MS 39402-8112 | 2020-03-10 |
| 1932740578 | Felisa Jeannette Hall | Nurse Practitioner | 216 Westover Dr, Hattiesburg, MS 39402-1374 | 2019-10-04 |
| 1164072278 | Vivian Wright Pittman | Nurse Practitioner | 108 Northwest Cir, Hattiesburg, MS 39401-4512 | 2019-09-19 |
| 1821650045 | Charlotte Denise Andrews | Nurse Practitioner | 198 Millpond Dr, Hattiesburg, MS 39401-5561 | 2019-07-08 |
| 1285107318 | Talphineta Alisha Kelly | Nurse Practitioner | 9 Waverly Cir, Hattiesburg, MS 39402-8375 | 2019-01-11 |
| 1467931642 | Shuntay Mccormick | Nurse Practitioner | 163 Augustine Dr, Hattiesburg, MS 39402-7836 | 2018-08-09 |
| 1548768260 | Tavithia Heidelburg | Nurse Practitioner | 4 Willow Pt Ste 40, Hattiesburg, MS 39402-1150 | 2018-01-28 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on DOROTHY D 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.