NICHOLAS JAY MOORE


Address: 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256
Phone: 2484655140

NICHOLAS JAY MOORE (NPI# 1265727556) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1265727556
Entity Type Individual
Full Name NICHOLAS JAY MOORE
Credential M.D.
Practice Address 26850 Providence Pkwy Ste 260
Novi
MI 48374-1256
Practice Telephone 2484655140
Practice Fax Number 2484655141
Mailing Telephone 2484655140
Mailing Fax Number 2484655141
Enumeration Date 2011-06-14
Last Update Date 2019-04-16
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207Q00000X Family Medicine 4301108292 MI Allopathic & Osteopathic Physicians
Y 207QS0010X Family Medicine
Specialization: Sports Medicine
4301108292 MI Allopathic & Osteopathic Physicians

Provider Secondary Practice Location

Address Telephone Number Fax Number
28300 Orchard Lake Rd, Suite 200, Farmington Hills, MI 483343704 2485398630
1225 S Latson Rd Ste 380, Howell, MI 488437643 2484655140 2484655141

Other Providers NICHOLAS MOORE

NPI Name Taxonomy Address Enumeration
1265042691 Nicholas Antonio Moore Pharmacist 604 Cherry Dr, Fairview Heights, IL 62208-2846 2020-07-31
1073017679 Nicholas M Moore Spec/Tech, Pathology 1653 W Congress Pkwy Ste 1173, Chicago, IL 60612-3833 2018-03-20
1417905092 Nicholas J.e. Moore Radiology 1390 Kelly Johnson Blvd, Colorado Springs, CO 80920-3908 2006-05-05
1093339491 Nicholas Simms Moore Student in an Organized Health Care Education/Training Program 330 Brookline Ave, Boston, MA 02215-5491 2020-06-01
1396372868 Nicholas Lawrence Moore Student in an Organized Health Care Education/Training Program 111 Colchester Ave, Burlington, VT 05401-1473 2020-03-25
1013550383 Nicholas Moore Nurse Anesthetist, Certified Registered 9333 Imperial Hwy, Downey, CA 90242-2812 2019-10-19
1336795509 Nicholas M Moore Psychologist 1848 Se 1st Ave, Fort Lauderdale, FL 33316-2875 2019-08-14
1225695703 Nicholas Jay Moore Dentist 440 E Tampa St, Springfield, MO 65806-1131 2019-05-21
1467017343 Nicholas Maximilian Moore Student in an Organized Health Care Education/Training Program 1250 E Marshall St, Richmond, VA 23298-5051 2019-05-06
1811421258 Nicholas Moore Student in an Organized Health Care Education/Training Program 9333 Park West Blvd, Suite 102, Knoxville, TN 37923-4341 2017-04-12

Office Location

Street Address 26850 PROVIDENCE PKWY STE 260
City NOVI
State MI
Zip Code 48374-1256

Providers in the same location

NPI Name Taxonomy Address Enumeration
1477011591 Shannon Elizabeth Manno Orthopaedic Surgery 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 2019-03-07
1962878249 Cassandra Lynn Herman Physician Assistant 26850 Providence Pkwy Ste 260, Novi, MI 48374-1256 2015-08-20

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1902323884 Jhansi Navuluri Physical Therapist 27579 Etrada Lane, Novi, MI 48374 2017-08-23
1609306422 James Vanderhaeghen Foster Care Agency 24375 Homestead Ct, Novi, MI 48374 2017-06-14
1558810622 Iryna Chaykivska Nurse Anesthetist, Certified Registered 47601 Grand River Avenue, Novi, MI 48374 2016-09-29
1477937944 Joseph Smola Chiropractor 48000 Grand River Ave, Novi, MI 48374 2015-07-15
1881005114 Alpha Medical Services PC Internal Medicine 26131, Sunbury Ct, Novi, MI 48374 2014-05-08
1043565443 Jason J Rizqallah Surgery 47601 Grand River Ave # B136, Novi, MI 48374 2012-07-21
1780992628 Khyati Patel Internal Medicine 26850 Providence Pkwy Ste 420, Novi, MI 48374 2010-09-14
1891963799 Luann Marie Redmond Social Worker 50598 Montana, Novi, MI 48374 2008-02-13
1427249424 Ajay V Raman Anesthesiology 24875 Novi Road #454, Novi, MI 48374 2007-08-05
1003948233 Sam's Club Optical Technician/Technologist 27300 Wixon Road, Novi, MI 48374 2007-03-12
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Taxonomy Information

Taxonomy Code 207QS0010X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine
Specialization Sports Medicine

Taxonomy Definition

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.

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1013413236 Sports and Regenerative Medicine Pllc Family Medicine 526 W Genesee St Ste 3, Frankenmuth, MI 48734-1357 2018-04-05
1982138442 Stephen Michael Spadafore Family Medicine 2951 Earhart Rd, Ann Arbor, MI 48105-9728 2017-04-11
1447606801 Central Michigan University Family Medicine Cmu Sports Medicine, Rose 100, Mt Pleasant, MI 48859-0001 2016-05-04
1962808162 Mclaren Greater Lansing Family Medicine 2479 Woodlake Cir, Suite 340, Okemos, MI 48864 2014-11-15
1306080213 Caroline E Beall Family Medicine 11160 Wj Presley Pkwy Ste 100, Allendale, MI 49401-8075 2009-04-22
1104038629 Robert Edward Poley Family Medicine 15959 Hall Rd Ste 405, Macomb, MI 48044 2007-05-04
1063563187 Lee Stephen Fruman Family Medicine 24670 S Cromwell Dr, Franklin, MI 48025-1644 2007-01-15
1366505802 Sports Medicine Associates,plc Family Medicine 3121 University Dr, Ste 140, Auburn Hills, MI 48326-2385 2006-12-18
1538220561 Thomas K Jamieson Family Medicine 2720 Pleasant Grove Rd, Lansing, MI 48910-2410 2006-12-13
1366550105 D-care PC Family Medicine 25932 Dequindre Rd, Suite C, Warren, MI 48091-1071 2006-08-29
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Competitor

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City NOVI
Zip Code 48374

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Dataset Information

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.

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