THOMAS C MOORE (NPI# 1184655060) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184655060 |
| Entity Type | Individual |
| Full Name | THOMAS C MOORE |
| Credential | MD |
| Practice Address |
1115 N Frontage Rd Vicksburg MS 39180-5102 |
| Practice Telephone | 6016348790 |
| Mailing Telephone | 6016348790 |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 14614 | MS | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | AETNA | 5699557 | 01 |
| MS | 00115748 | 05 | |
| LA | 1693804 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700410081 | Thomas Earl Moore | Nurse Practitioner | 5575 Dana Dr, Ashland, KY 41102-9647 | 2020-02-26 |
| 1760923775 | Thomas Moore II | Physical Therapist | 5100 Paschall Dr, Durham, NC 27705-8534 | 2017-03-10 |
| 1437509429 | Thomas Anthony Moore | Occupational Therapist | 180 Thompson Rd, Crossville, TN 38571-0755 | 2016-06-21 |
| 1871970194 | Thomas Edward Moore | Counselor | 3937 S St Se Apt A8, Washington, DC 20020-1009 | 2015-05-06 |
| 1184039364 | Thomas Moore | Psychologist | 169 Libbey Industrial Pkwy Fl 2, Weymouth, MA 02189-3101 | 2014-06-25 |
| 1821372087 | Thomas Lowell Moore | Counselor | 1711 Hermitage Dr, Florence, AL 35630-2517 | 2011-10-06 |
| 1457537896 | Thomas L Moore | Counselor | 310 E. Lake St., Tom Moore, Mccall, ID 83638 | 2008-01-16 |
| 1376740126 | Thomas Moore Jr. | Social Worker | 2630 Skylark Rd, Wilmington, DE 19808-1634 | 2007-06-27 |
| 1013123561 | Thomas Marion Moore | Pharmacist | 4305 Peninsula Pt, Greenville, NC 27834-0520 | 2007-05-14 |
| 1164580221 | Thomas James Moore | Family Medicine | 99 E Carmel Drive, Suite E, Carmel, IN 46032 | 2006-12-04 |
| Street Address |
1115 N FRONTAGE RD |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39180-5102 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659307791 | Vicksburg Clinic LLC | Surgery | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-23 |
| 1154532257 | Vicksburg Clinic LLC | Durable Medical Equipment & Medical Supplies | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2007-05-24 |
| 1639259518 | Robert Clifton Strong | Anesthesiology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-10-16 |
| 1992730998 | Rebecca Tustain | Nurse Practitioner | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-11 |
| 1861423766 | Philip L Scurria | Psychiatry & Neurology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-07-06 |
| 1831127422 | Gordon W Sluis | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180 | 2006-06-30 |
| 1801824495 | Anita L Tribble | Internal Medicine | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-30 |
| 1164450755 | Gray Hilsman | Psychiatry & Neurology | 1115 N Frontage Rd, Vicksburg, MS 39180-5102 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255877346 | Elite Performance and Rehab, LLC | Clinic/Center | 1901 A Mission 66, Vicksburg, MS 39180 | 2017-01-12 |
| 1679931083 | Heather M Anderson | Physician Assistant | 2080 S Frontage Rd Ste 100, Vicksburg, MS 39180 | 2016-02-01 |
| 1245604941 | Warren County Assn.for Retarded Citizens, Inc. | Day Training, Developmentally Disabled Services | 100 Smokey Lane, Vicksburg, MS 39180 | 2015-11-18 |
| 1386012904 | Brian Oliver Snowden | Counselor | 3530 Manor Dr Ste 5a, Vicksburg, MS 39180 | 2015-09-14 |
| 1962802710 | Jordan P. Crocker, D.m.d., Pllc | Clinic/Center | 109 Monument Place, Vicksburg, MS 39180 | 2014-08-29 |
| 1821434259 | Trisha Addison | Physical Therapist | 2222 South Frontage Road, Suite D, Vicksburg, MS 39180 | 2013-05-13 |
| 1073862157 | Laura Jeanne Briggs | Physical Therapist | 1901-a Mission 66, Vicksburg, MS 39180 | 2012-09-05 |
| 1912175258 | Andrea T. Harris | Counselor | Warren-yazoo Mental Health Service, 3444 Wisconsin Ave., Vicksburg, MS 39180 | 2008-02-20 |
| 1922217314 | Austin Family Dentistry | Dentist | 3040 Indiana Ave, Vicksburg, MS 39180 | 2007-05-22 |
| 1063539138 | Ollie Hardaway Jr. | Dentist | 154 Cottonwood Street, Vicksburg, MS 39180 | 2007-03-23 |
| Find all providers in zip 39180 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689038630 | Lauren Dean Mckinney | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2016-04-06 |
| 1346344421 | Izzeddin Kamelmaz | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-09-11 |
| 1831127422 | Gordon W Sluis | Pediatrics | 1115 N Frontage Rd, Vicksburg, MS 39180 | 2006-06-30 |
| 1841228087 | Deborah Smith | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-28 |
| 1639115173 | Elizabeth N Roy | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-22 |
| 1700821931 | Geri L Weiland | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-19 |
| 1033154794 | Lisa D Fairchild | Pediatrics | 2100 Highway 61 N, Vicksburg, MS 39183-8211 | 2006-06-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508464181 | Meredith Sanford | Pediatrics | 101 Farm View Dr, Oxford, MS 38655-7728 | 2020-10-15 |
| 1255947297 | Gluckstadt Tc Kids, LLC | Pediatrics | 101 Lexington Dr Ste A, Madison, MS 39110-6986 | 2020-09-16 |
| 1982224895 | Vpa PC | Pediatrics | 111 E Capitol St Ste 215, Jackson, MS 39201-2108 | 2020-04-21 |
| 1992356166 | Marcie P Errington | Pediatrics | 3110 Sumrall Rd, Crystal Springs, MS 39059-8955 | 2019-09-27 |
| 1235635566 | North Mississippi Medcial Center, Inc. | Pediatrics | 1150 S Green St Ste D, Tupelo, MS 38804-4901 | 2018-04-04 |
| 1538675798 | The Pedz Clinic | Pediatrics | 610 3rd St Sw, Magee, MS 39111-3994 | 2017-12-22 |
| 1841715539 | Happicare One LLC Ppec Pediatric Daycare | Pediatrics | 213 W Park Ave, Greenwood, MS 38930-3008 | 2017-08-03 |
| 1336598028 | Andrea Logan Md | Pediatrics | 3631 Bienville Blvd Ste B, Ocean Springs, MS 39564-5702 | 2016-06-03 |
| 1730541640 | Stephanie Harrell | Pediatrics | 309 Llewellyn Ave, Mccomb, MS 39648-2703 | 2016-03-22 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
| Find all providers with the same taxonomy | ||||
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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.