SCOTT RANDALL MOORE (NPI# 1174613053) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174613053 |
| Entity Type | Individual |
| Full Name | SCOTT RANDALL MOORE |
| Credential | PA-C |
| Practice Address |
2880 Nw Stewart Pkwy Suite 100 Roseburg OR 97471-1201 |
| Mailing Address |
Po Box 833 Winchester OR 97495-0833 |
| Practice Telephone | 5416732267 |
| Practice Fax Number | 5416729483 |
| Mailing Telephone | 5416732267 |
| Mailing Fax Number | 5416732267 |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2017-10-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA01382 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316182678 | Scott Robert Moore | Massage Therapist | 565 S 250 E, Ivins, UT 84738-5010 | 2008-12-15 |
| 1497709513 | Scott Macleod Moore | Pediatrics | 13699 Old Us 12, Chelsea, MI 48118 | 2006-05-22 |
| 1780674358 | Scott Marshall Moore | Chiropractor | 1701 Shepherd Rd, Lakeland, FL 33811-2179 | 2005-10-25 |
| 1861490476 | Scott Garner Moore | Family Medicine | 174 Highway 113, Flomaton, AL 36441-4556 | 2005-07-08 |
| 1699249045 | Scott Moore | Social Worker | 14426 S Outer 40 Rd, Town and Country, MO 63017-5711 | 2019-01-18 |
| 1043683204 | Scott Moore | Pharmacist | 881 W Buchanan St, Prairie Grove, AR 72753-2880 | 2015-11-09 |
| 1619356961 | Scott Richard Moore | Internal Medicine | 1 Cooper Plz, Camden, NJ 08103-1461 | 2015-05-20 |
| 1932510351 | Scott Anthony Moore | Substance Abuse Rehabilitation Facility | 69 Arrowhead Loop, Canadian, OK 74425-5012 | 2014-05-20 |
| 1184062556 | Scott Emory Moore | Nurse Practitioner | 701 Grove Rd, Greenville, SC 29605-4210 | 2013-06-07 |
| 1629363858 | Scott Moore | Pharmacist | 275 S River Rd, St George, UT 84790-2116 | 2011-06-15 |
| Street Address |
2880 NW STEWART PKWY SUITE 100 |
| City | ROSEBURG |
| State | OR |
| Zip Code | 97471-1201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457351991 | Community Cancer Foundation | Clinic/Center | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 | 2005-07-27 |
| 1982833752 | Community Cancer Foundation | Dietitian, Registered | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 | 2009-07-14 |
| 1003982281 | Umpqua Medical PC | Internal Medicine | 2880 Nw Stewart Pkwy, Suite 200, Roseburg, OR 97471-1201 | 2006-11-28 |
| 1376639153 | Community Cancer Foundation | Clinic/Center | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1201 | 2006-10-05 |
| 1124079140 | Michael L Brown | Radiology | 2880 Nw Stewart Pkwy, Suite 100, Roseburg, OR 97471-1202 | 2006-05-15 |
| 1134103252 | Michael C Oneil Jr. | Internal Medicine | 2880 Nw Stewart Pkwy, Suite 301, Roseburg, OR 97471-1206 | 2005-12-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841805660 | Rae Ann Barnes | Pharmacist | 913 Ne Garden Valley Blvd, Pharmacy, Roseburg, OR 97471 | 2020-09-09 |
| 1023651031 | Colton Phillips | Behavioral Analyst | 940 Nw Garden Valley Bvld #104, Roseburg, OR 97471 | 2019-10-22 |
| 1952884876 | Meredith Krugel Lcsw PC | Clinic/Center | 2225 Nw Stewart Parkway Ste 200, Roseburg, OR 97471 | 2018-09-07 |
| 1114456563 | Philip Kaser Family, LLC | Pharmacy | 1175 W. Harvard Avenue, Roseburg, OR 97471 | 2017-06-08 |
| 1053854208 | Icco LLC | Clinic/Center | 1740 Nw Goetz Street, Roseburg, OR 97471 | 2016-11-21 |
| 1770034589 | Evie Jepsen | Case Manager/Care Coordinator | 2700 Stewart Parkway Annex B, Suite 110, Roseburg, OR 97471 | 2016-10-17 |
| 1932551256 | Jonathan Schmidt | Licensed Practical Nurse | 913 Nm Garden Valley Blvd, Va Roseburg Medical Center, Roseburg, OR 97471 | 2016-07-11 |
| 1932580586 | Jeffrey Mark Wareham | Case Manager/Care Coordinator | 2700 Medical Loop, Annex B, Roseburg, OR 97471 | 2015-06-09 |
| 1558784215 | Ginger Jean Thibedeau | Massage Therapist | 3019 Nw Stewart Parkway, Suite 304 #183, Roseburg, OR 97471 | 2014-01-30 |
| 1427303122 | Karishma Parekh | Internal Medicine | 2460 Nw Stewart Pkwy Ste 103, Roseburg, OR 97471 | 2012-07-18 |
| Find all providers in zip 97471 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902412505 | Lisa Mai | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1214 | 2020-09-18 |
| 1609480359 | Jacob Watters | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2020-09-01 |
| 1851937924 | Thanita Pradhanang | Physician Assistant | 1740 Nw Goetz St, Roseburg, OR 97471-1613 | 2019-11-22 |
| 1679129753 | Shannon Danette Trammell | Physician Assistant | 340 Nw Medical Loop, Roseburg, OR 97471-1645 | 2019-08-14 |
| 1144885575 | Michael Peterson | Physician Assistant | 2801 Nw Mercy Dr Ste 300, Roseburg, OR 97471-2348 | 2019-05-01 |
| 1962978866 | Kaitlyn E Bogardus | Physician Assistant | 2570 Nw Edenbower Blvd Ste 100, Roseburg, OR 97471-6214 | 2018-10-17 |
| 1740761519 | Alex Renee Shaffer | Physician Assistant | 150 Ne Kenneth Ford Dr, Roseburg, OR 97470-1042 | 2018-08-28 |
| 1629554811 | Gary Sorcher | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-11 |
| 1548756158 | Timothy Lawrence Garvey Jr. | Physician Assistant | 2700 Nw Stewart Pkwy, Roseburg, OR 97471-1281 | 2018-07-06 |
| 1437641404 | Michael F Graham | Physician Assistant | 2570 Nw Edenbower Blvd., Suite 100, Roseburg, OR 97471-6214 | 2018-06-05 |
| Find all providers in ROSEBURG | ||||
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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.