MOORE EMERGENCY PHYSICIANS, LLC (NPI# 1497774616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497774616 |
| Entity Type | Organization |
| Organization Name | MOORE EMERGENCY PHYSICIANS, LLC |
| Practice Address |
700 S Telephone Rd Moore OK 73160-2502 |
| Mailing Address |
5925 N Ann Arbor Ave Oklahoma City OK 73122-7526 |
| Practice Telephone | 4057939355 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JERRY D BRINDLEY (PRESIDENT) |
| Authorized Official Telephone | 4056046000 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207PE0004X |
Emergency Medicine Specialization: Emergency Medical Services |
Allopathic & Osteopathic Physicians |
| Street Address |
700 S TELEPHONE RD |
| City | MOORE |
| State | OK |
| Zip Code | 73160-2502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922009075 | Senthil K Raju | Family Medicine | 700 S Telephone Rd, Moore, OK 73160-2502 | 2005-08-10 |
| 1588262240 | Brian Michael | Social Worker | 700 S Telephone Rd, Moore, OK 73160-2550 | 2020-10-15 |
| 1568085504 | Osu Center for Health Sciences | Clinic/Center | 700 S Telephone Rd, Moore, OK 73160-2502 | 2020-05-26 |
| 1992338776 | Bruce Allan Rau | Occupational Therapist | 700 S Telephone Rd, Moore, OK 73160-2550 | 2020-02-19 |
| 1275179939 | Christina Zitzow | Occupational Therapist | 700 S Telephone Rd, Moore, OK 73160-2550 | 2019-11-18 |
| 1972148740 | Karinda Polk | Physical Medicine & Rehabilitation | 700 S Telephone Rd, Moore, OK 73160-2550 | 2019-11-15 |
| 1831734052 | Kimberly Cusher | Physical Therapist | 700 S Telephone Rd, Moore, OK 73160-2550 | 2019-11-12 |
| 1508317041 | Stacy Hyden | Physical Therapist | 700 S Telephone Rd, Moore, OK 73160-2502 | 2016-10-19 |
| 1275081127 | Anna Tooman | Physical Therapist | 700 S Telephone Rd, Moore, OK 73160-2502 | 2016-09-20 |
| 1023566114 | John Do | Physical Therapist | 700 S Telephone Rd, Moore, OK 73160-2502 | 2016-09-16 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225678576 | Crystal Amanda Pitts | Student in an Organized Health Care Education/Training Program | 628 Allison Ln, Moore, OK 73160 | 2020-01-14 |
| 1982247623 | Tammie Lee Haworth | Occupational Therapy Assistant | Quest, 400 N Eastern Ave, Moore, OK 73160 | 2019-10-25 |
| 1477102580 | Php Management Group, LLC | Non-Pharmacy Dispensing Site | 1110 Magnolia Court, Moore, OK 73160 | 2019-09-11 |
| 1477117893 | Pharmology Moore LLC | Pharmacy | 1280 N Eastern Ave, Suite F, Moore, OK 73160 | 2019-05-01 |
| 1154891943 | Leah Cordell | Nurse Practitioner | 1280 North Eastern Ave., Suite F, Moore, OK 73160 | 2018-12-05 |
| 1467962332 | Healthcare Express, LLP | Clinic/Center | 551 Se 4th Street, Moore, OK 73160 | 2017-10-05 |
| 1306379557 | Dicarlo Venegas | Behavior Technician | 716 Wood Hollow Ln, Moore, OK 73160 | 2017-04-05 |
| 1073050167 | Tyron Dorrell Cosby Sr. | Case Manager/Care Coordinator | 1416 Penn Ln., Moore, OK 73160 | 2017-01-26 |
| 1326592650 | Kristin Kelley | Counselor | 1113 S Avery Dr, Moore, OK 73160 | 2016-08-03 |
| 1376912600 | Allison Kay Griffiths | Counselor | 9501 S. I-35 Service Rd, Apt 1504, Moore, OK 73160 | 2015-09-16 |
| Find all providers in zip 73160 | ||||
| Taxonomy Code | 207PE0004X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Emergency Medical Services |
| An emergency medicine physician who specializes in non-hospital based emergency medical services (e.g., disaster site, accident scene, transport vehicle, etc.) to provide pre-hospital assessment, treatment, and transport patients. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285978007 | Medicine Wheel Inc | Emergency Medicine | 128 Buffalo Street, Caddo, OK 74729 | 2012-11-16 |
| 1326149048 | Nadim N Daher | Emergency Medicine | 802 S Jackson Ave Ste 310, Tulsa, OK 74127-9057 | 2006-09-26 |
| 1578512596 | Medhat S.f. Michael | Emergency Medicine | 1265 E 33rd St, Edmond, OK 73013-6307 | 2006-05-08 |
| 1639137409 | Jerry C Childs Jr. | Emergency Medicine | 1520 Morning Star, Edmond, OK 73034-6579 | 2006-05-02 |
| 1134186299 | Boyd David Burns | Emergency Medicine | 4502 E. 41st St, Tulsa, OK 74135-9923 | 2006-05-01 |
| 1649235532 | Stephen R Gilliland | Emergency Medicine | 8813 S 71st East Ave, Tulsa, OK 74133-5056 | 2006-04-20 |
| 1811959166 | Andrew Mark Hoelscher | Emergency Medicine | 8105 Nw Expressway, Oklahoma City, OK 73162-6004 | 2006-04-03 |
| 1841260015 | Joseph M. Nicholson IIi | Emergency Medicine | 1435 S Utica Ave, Tulsa, OK 74104-4649 | 2006-01-23 |
| 1518947100 | Elizabeth S Monnot | Emergency Medicine | 503 S Aspen Ave, Broken Arrow, OK 74012-2296 | 2006-01-19 |
| 1225018757 | Stanley R Stacy | Emergency Medicine | 7153 S Yale Ave, Tulsa, OK 74136-6308 | 2006-01-19 |
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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.