DR. ROYCE DAVID MOORE (NPI# 1205157641) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205157641 |
| Entity Type | Individual |
| Full Name | DR. ROYCE DAVID MOORE |
| Credential | M.D. |
| Practice Address |
3050 E River Bluff Blvd Ozark MO 65721-8807 |
| Practice Telephone | 4178207969 |
| Mailing Telephone | 4178207969 |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2020-07-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | TP188 | KY | Allopathic & Osteopathic Physicians |
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
2014014739 | MO | Allopathic & Osteopathic Physicians |
| N | 207XX0005X |
Orthopaedic Surgery Specialization: Sports Medicine |
2014014739 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 1205157641 | 05 |
| Street Address |
3050 E RIVER BLUFF BLVD |
| City | OZARK |
| State | MO |
| Zip Code | 65721-8807 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528094695 | Jeffrey S. Delvecchio | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2006-06-23 |
| 1366077240 | Daniel Ellis | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2020-03-11 |
| 1619532686 | Caitlyn Oxenreider | Nurse Practitioner | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2019-05-06 |
| 1609357383 | Whitney Moser | Registered Nurse | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2018-08-22 |
| 1457843740 | Hillary Gale Roberts | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2018-06-01 |
| 1750885901 | Ashley M Shaw | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2018-03-22 |
| 1821590142 | Cody L Giedd | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2018-03-02 |
| 1427575901 | Mercy Pharmacy Services, LLC | Pharmacy | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2017-08-25 |
| 1659758134 | Sarah Agnes Eck Tipton | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2015-05-04 |
| 1528461621 | Justin R Allphin | Physician Assistant | 3050 E River Bluff Blvd, Ozark, MO 65721-8807 | 2014-10-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063054880 | Ramya Sravani Pakala | Family Medicine | 5571 N. 21st St., Ozark, MO 65721 | 2019-10-14 |
| 1871073346 | Regional Services | Nurse Practitioner | 1350 W Bluff Dr, Ozark, MO 65721 | 2018-08-15 |
| 1932602125 | Clarence William Jaggard Jr. | Family Medicine | Ozark Valley Medical Clinic 5571 N. 21st St., Ozark, MO 65721 | 2018-03-14 |
| 1053826750 | Veronica Keller | Speech-Language Pathologist | 3608 N. Highway Nn, Ozark, MO 65721 | 2017-12-05 |
| 1124546304 | Kara Nicole Peterson | Speech-Language Pathologist | 302 N 4th Ave., Ozark, MO 65721 | 2017-09-07 |
| 1912391368 | Mobile X-ray Services, LLC | Clinic/Center | 3050 N. 20th Street, Ozark, MO 65721 | 2015-03-24 |
| 1073787289 | Melissa Milan | Counselor | 332 South 3rd Street, Ozark, MO 65721 | 2008-04-17 |
| 1306038948 | Preferred Hospice of Missouri Southwest LLC | Hospice Care, Community Based | 1567 West Diane, Suite B, Ozark, MO 65721 | 2007-08-17 |
| 1508073040 | Retirement At Century Pines Inc. | Assisted Living Facility | 709 E. Mccracken, Ozark, MO 65721 | 2007-05-16 |
| 1184844482 | Ozark Medical Imaging Center | Radiology | 1500 W State Hwy J, Ozark, MO 65721 | 2007-04-27 |
| Find all providers in zip 65721 | ||||
| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871105312 | 417 Sports Medicine and Orthopedics LLC | Family Medicine | 330 W Plainview Rd Ste F, Springfield, MO 65810-2672 | 2020-08-17 |
| 1871115857 | Ben Heimos | Family Medicine | 1 S Compton Ave, Saint Louis, MO 63103-2001 | 2020-05-12 |
| 1639645070 | Bluetail Biologics LLC | Family Medicine | 17300 N Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2018-10-23 |
| 1083096671 | Daniel O'loughlin | Family Medicine | 1605 Martin Springs Dr Ste 330, Rolla, MO 65401-2980 | 2015-06-19 |
| 1295175057 | Devin Willis | Family Medicine | 16555 Manchester Rd Ste 100, Wildwood, MO 63040 | 2013-06-26 |
| 1922377274 | Duocorp Enterprises, LLC | Family Medicine | 1525 E Republic Rd, Suite A115, Springfield, MO 65804-6527 | 2011-12-15 |
| 1689960171 | Nathan Lee Granneman | Family Medicine | 200 Corporate Lake Dr, Columbia, MO 65203-7172 | 2011-06-22 |
| 1063568640 | Christian Verry | Family Medicine | 12680 Olive Blvd Ste 300, Saint Louis, MO 63141-6322 | 2007-01-26 |
| 1922116763 | Kristin Suzanne Oliver | Family Medicine | 17300 North Outer 40 Rd Ste 201, Chesterfield, MO 63005-1364 | 2006-08-29 |
| 1942238027 | John J Dougherty | Family Medicine | 1010 Carondelet Dr Ste 220, Kansas City, MO 64114-4822 | 2006-06-29 |
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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.