PAUL DEREK MOORE (NPI# 1417945700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417945700 |
| Entity Type | Individual |
| Full Name | PAUL DEREK MOORE |
| Credential | MD |
| Practice Address |
815 Cumberland St Suite 205 Lebanon PA 17042-5266 |
| Mailing Address |
100 N Cameron St Suite 401e Harrisburg PA 17101-2424 |
| Practice Telephone | 7172777400 |
| Practice Fax Number | 7172777402 |
| Mailing Telephone | 7172328535 |
| Mailing Fax Number | 7172328515 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2016-09-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 40759 | CO | Allopathic & Osteopathic Physicians |
| Y | 208D00000X | General Practice | MD444618 | PA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 09932861 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649661356 | Paul Lloyd Moore | Social Worker | 516 Ravenwood Dr, Indian Land, SC 29707-9690 | 2015-02-17 |
| 1558782995 | Paul Moore | Counselor | 900 S Giddings St., Visalia, CA 93277 | 2014-01-03 |
| 1639238264 | Paul T Moore | Dentist | 306 South Shady Ave., Damascus, VA 24236 | 2006-12-08 |
| 1912092156 | Paul Terrence Moore | Specialist | 8722 Greenville Ave, Bldg. E Suite 102, Dallas, TX 75243-7167 | 2006-10-04 |
| 1326002023 | Paul E Moore | Family Medicine | 110 3rd St Ste 250, Henderson, KY 42420-5802 | 2006-04-12 |
| 1457906737 | Paul Benjamin Moore | Pediatrics | 1 Perkins Sq, Akron, OH 44308-1063 | 2019-08-05 |
| 1356841118 | Paul Edward Moore | Psychologist | 1221 Abrams Rd Ste 325, Richardson, TX 75081-5579 | 2018-02-19 |
| 1942688981 | Paul Moore | Nurse Anesthetist, Certified Registered | 3400 Spruce St, Philadelphia, PA 19104-4238 | 2015-05-11 |
| 1659717163 | Paul Moore | Nutritionist | 108 Doctors Dr, Boone, NC 28607-5000 | 2013-05-13 |
| 1194065854 | Paul H Moore | Physical Therapy Assistant | 401 W Martintown Rd, Suite 169, North Augusta, SC 29841-3186 | 2013-02-18 |
| Street Address |
815 CUMBERLAND ST SUITE 205 |
| City | LEBANON |
| State | PA |
| Zip Code | 17042-5266 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023676384 | Sandra L Pistone | Registered Nurse | 905 S. 2nd Ave, Lebanon, PA 17042 | 2019-06-03 |
| 1154848414 | Kihc, LLC | Home Health | 900-c Centerville Road, Suite C, Lancaster, PA 17042 | 2017-08-28 |
| 1316301724 | Good Samaritan Physician Services | Radiology | 844 Tuck Street, Lebanon, PA 17042 | 2016-04-12 |
| 1609265883 | Ashley Hess | Behavioral Analyst | 15th South 9th Street, Lebanon, PA 17042 | 2015-01-12 |
| 1932504727 | Anthony Salvadore Petrole | Physician Assistant | 252 4th Street, Lebanon, PA 17042 | 2014-10-23 |
| 1801209713 | Matthew Johnson | Family Medicine | 920 Church Street, Lebanon, PA 17042 | 2014-06-09 |
| 1437414505 | Odalys Gonzalez-rodriguez | Physical Therapist | 1700 S Lincoln Ave., Lebanon Vmac Bldg 102 Room 120, Lebanon, PA 17042 | 2012-07-05 |
| 1750677175 | Anita Lyn Stokes | Speech-Language Pathologist | 1126 Walnut Street, Lebanon, PA 17042 | 2011-06-23 |
| 1205126497 | Karey Lynn Foote | Pharmacist | 415 S. 9th St, Lebanon, PA 17042 | 2011-04-09 |
| 1013227685 | T. W. Ponessa and Associates Counseling Services, Inc. | Community/Behavioral Health | 101 E. Evergreen Road, Lebanon, PA 17042 | 2010-10-18 |
| Find all providers in zip 17042 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851551998 | James R Mcafee | General Practice | 1997 Terrace Ln, Lebanon, IN 46052 | 2008-06-12 |
| 1043205008 | Thomas A Kowal | General Practice | 228 W Main St Ste B, Lebanon, TN 37087-2681 | 2005-09-15 |
| 1861993263 | Healthcare for Kids & Teens, Pllc | General Practice | 54 Miller Pike, Lebanon, KY 40033-9248 | 2018-02-22 |
| 1114451267 | Morgan Cameron Wimmer | General Practice | 200 Mullins Dr, Lebanon, OR 97355-3983 | 2017-04-16 |
| 1619137825 | James Chad Greene | General Practice | 1 Medical Center Dr, Dhmc, Lebanon, NH 03756-1000 | 2008-06-11 |
| 1932392289 | Morris Dean Ferguson | General Practice | 500 Park Ave, Lebanon, TN 37087-3721 | 2007-08-21 |
| 1295805950 | Alice Peck Day Memorial Hospital | General Practice | 10 Alice Peck Day Dr, Lebanon, NH 03766-2647 | 2006-11-09 |
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| 1831755735 | Good Hope Health Center Corp | General Practice | 7712 Buist Ave, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1366008260 | Ltc Treatment Center Inc | General Practice | 7712 Buist Ave Apt B, Philadelphia, PA 19153-1705 | 2019-05-15 |
| 1003479825 | Marsha Frances Santangelo | General Practice | 107 Sawgrass Drive, Blue Bell, PA 19422 | 2019-04-17 |
| 1972072288 | Paula Alejandra Pino Pommer | General Practice | 3551 North Broad St., Philadelphia, PA 19140-4160 | 2018-11-15 |
| 1033686159 | Star Wellness Center, Inc | General Practice | 511 E 3rd St Ste 202, Bethlehem, PA 18015-2180 | 2018-10-26 |
| 1891277620 | Donald C. Cameron | General Practice | 718 Kennett Pike, Chadds Ford, PA 19317 | 2018-08-29 |
| 1124510888 | Healing Place Medical, P.C. | General Practice | 1600 Horizon Dr Ste 122123, Chalfont, PA 18914-4100 | 2018-05-30 |
| 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.