CARL LINARD MOORE (NPI# 1205107877) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205107877 |
| Entity Type | Individual |
| Full Name | CARL LINARD MOORE |
| Practice Address |
3200 Juanipero Way Medford OR 97504-8580 |
| Mailing Address |
3587 Heathrow Way Medford OR 97504-4004 |
| Practice Telephone | 5418164131 |
| Practice Fax Number | 4582262163 |
| Mailing Telephone | 5418588170 |
| Mailing Fax Number | 5418588167 |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2019-06-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 918 King St, Medford, OR 975013414 | 5413244138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033475850 | Carl Moore | Counselor | 1901 Mlk Jr Way S, Seattle, WA 98144-4801 | 2012-04-05 |
| 1972610400 | Carl Moore | Physical Therapist | 2400 Hospital Road, Tuskegee, AL 36083 | 2006-08-23 |
| 1083698468 | Carl Moore | Internal Medicine | 2410 Atherholt Rd, Lynchburg, VA 24501-2148 | 2005-11-30 |
| Street Address |
3200 JUANIPERO WAY |
| City | MEDFORD |
| State | OR |
| Zip Code | 97504-8580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730382615 | Janice Witt | Counselor | 3200 Juanipero Way, Medford, OR 97504 | 2007-06-07 |
| 1558976506 | Shara Ann Conner | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-09-15 |
| 1225643364 | Kevin Joseph Cain | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-09-15 |
| 1801400510 | Steven Diego Cordoba | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-09-01 |
| 1902424948 | Christopher Joseph D'amore | Registered Nurse | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-07-07 |
| 1952923088 | Leah Dionne Lemke | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-05-12 |
| 1679193155 | Erin Frances Oltman | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2020-04-24 |
| 1851934913 | Stacey Lee Daniszewski | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2019-10-22 |
| 1497398556 | Dana Annette Daniels | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2019-10-22 |
| 1114569779 | Jennifer Lucania Walker | Counselor | 3200 Juanipero Way, Medford, OR 97504-8580 | 2019-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225673833 | Lydia D Sneed | Behavioral Analyst | 3707 Citation Way, Suite 102, Medford, OR 97504 | 2019-11-07 |
| 1114577368 | Heather Ashley Fronek | Nurse Practitioner | 2825 E. Barnett Rd., Medford, OR 97504 | 2019-09-18 |
| 1255809109 | Justin Blasdel | Technician, Health Information | 3250 Lone Pine Rd, Medford, OR 97504 | 2018-11-08 |
| 1396220133 | Aimee K Michel | Massage Therapist | 3550 National Dr., Medford, OR 97504 | 2018-09-27 |
| 1437646908 | Zola Dental Medford LLC | Dentist | 922 E Main, Medford, OR 97504 | 2018-04-19 |
| 1376068015 | Megan Leggett | Counselor | 777 Murphy Road, Medford, OR 97504 | 2017-08-03 |
| 1023547536 | Joshua Morgan Rice | Dentist | 1117 E Main St Ste 1, Medford, OR 97504 | 2017-06-08 |
| 1427580232 | Paul James Dean | Counselor | 1175 Main St Ste 1c, Medford, OR 97504 | 2017-03-30 |
| 1811443542 | Taya Adams | Doula | 1201 Progress Dr #90, Medford, OR 97504 | 2016-09-01 |
| 1174076228 | Avalon Health Care - Hearthstone, LLC | Skilled Nursing Facility | 2091 E. Barnett Road, Medford, OR 97504 | 2016-07-25 |
| Find all providers in zip 97504 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911091 | Araceli Olivares Mciff | Counselor | 201 W 6th St Ste 101, Medford, OR 97501-2708 | 2020-08-04 |
| 1366069494 | Brian Snapp | Counselor | 1191 Hazel St, Medford, OR 97501 | 2020-07-06 |
| 1477174761 | Corey Renfree | Counselor | 1191 Hazel Street, Medford, OR 97501 | 2020-04-28 |
| 1326674417 | Jean Yih Kingston | Counselor | Dcs Mental Health Medford, 151 Mystic Avenue, Medford, MA 02155-4632 | 2020-03-20 |
| 1063059228 | Chiron Center Incorporated | Counselor | 2909 N Phoenix Rd, Medford, OR 97504-9490 | 2019-12-06 |
| 1790321784 | Cassandra F Lawrence | Counselor | 1503 Race Ave, Medford, NY 11763-1859 | 2019-11-25 |
| 1427691955 | Claire Elizabeth Ann Vos | Counselor | 807 Impala Dr, Medford, WI 54451-1206 | 2019-10-28 |
| 1033768718 | Hope Koram | Counselor | 15 Carberry St, Medford, MA 02155-1804 | 2019-09-05 |
| 1649767203 | Kerry Ellis | Counselor | 190 High St Apt 210, Medford, MA 02155-3810 | 2018-04-19 |
| 1942701271 | Winding Tree Counseling Services LLC | Counselor | 916 W 10th St Ste 100, Medford, OR 97501-3018 | 2018-02-22 |
| Find all providers in MEDFORD | ||||
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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.