BRET A MOORE (NPI# 1639108004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639108004 |
| Entity Type | Individual |
| Full Name | BRET A MOORE |
| Credential | PA-C |
| Practice Address |
920 N Quincy Ave Ottumwa IA 52501-3866 |
| Practice Telephone | 6414555200 |
| Practice Fax Number | 6414555150 |
| Mailing Telephone | (641) 455-5200 |
| Mailing Fax Number | 6414555150 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2017-07-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 087087 | IA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA162693 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 1436 | NE | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | PA10004070 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IA | MEDICARE PTAN | 560910078 | 01 |
| WA | L&I | 0219804 | 01 |
| IA | IOWA LICENSE | 087087 | 01 |
| WA | 8354698 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558407932 | Bret Andrew Moore | Psychologist | 3551 Roger Brooke Dr, Jbsa Ft Sam Houston, TX 78234-4504 | 2007-01-30 |
| Street Address |
920 N QUINCY AVE |
| City | OTTUMWA |
| State | IA |
| Zip Code | 52501-3866 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841294881 | Joseph Ira Coleman | Obstetrics & Gynecology | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2005-06-08 |
| 1649704370 | Christina Noel Kelley | Physician Assistant | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2017-04-19 |
| 1538601968 | Jennifer Ann Boley | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2016-11-16 |
| 1215316401 | Allison Marie Crall | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2015-05-21 |
| 1245671122 | Shelly Ann Edwards | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2013-07-08 |
| 1508101221 | Pella Regional Health Center | Clinic/Center | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2012-12-06 |
| 1407156458 | David Lee Burrows | Nurse Practitioner | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2010-10-25 |
| 1740500099 | Heidi Leigh Van Maanen | Family Medicine | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2010-06-09 |
| 1548236664 | Elizabeth Siitari | Family Medicine | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2006-02-28 |
| 1447225123 | Stewart John Kanis | Family Medicine | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2006-02-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205327210 | Speer Family Chiropractic, LLC | Chiropractor | 635 Pennsylvania Ave, Ottumwa, IA 52501 | 2018-05-24 |
| 1982194874 | Jasmine Benson | Nurse Practitioner | 1013 Pennsylvania Avenue, Suite A/b, Ottumwa, IA 52501 | 2018-05-16 |
| 1265957567 | Katie Marie Walz | Registered Nurse | 725 W. Second St., Ottumwa, IA 52501 | 2017-08-08 |
| 1033648431 | Cassadie Roberts | Occupational Therapy Assistant | 3 Pennsylvania Place, Ottumwa, IA 52501 | 2017-06-08 |
| 1588900880 | Ottumwa Er LLC | Emergency Medicine | 1001 Pennsylvania Avenue, Ottumwa, IA 52501 | 2012-12-14 |
| 1710258009 | Alcohol & Drug Dependency Services | Clinic/Center | 226 West Main St., Ottumwa, IA 52501 | 2012-01-19 |
| 1477832921 | Melissa Rohrssen | Physical Therapy Assistant | 13 Bear Creek Estates Drive, Ottumwa, IA 52501 | 2011-08-15 |
| 1578855201 | Brandy S.n. Jeansimon | Obstetrics & Gynecology | 1001 E. Pennsylvania Avenue, Ottumwa, IA 52501 | 2011-05-13 |
| 1801120399 | Frank Sam Harper | Counselor | 310 W. Main St., Ottumwa, IA 52501 | 2009-09-30 |
| 1902078439 | Sandro Younadam | Internal Medicine | 1013 Pennsylvania Avenue Suite A, Ottumwa Regional Health Center, Ottumwa, IA 52501 | 2008-03-25 |
| Find all providers in zip 52501 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609078609 | Alane Louise Webber | Physician Assistant | 1221 N Court St, Ottumwa, IA 52501-1909 | 2007-06-01 |
| 1306823281 | Molly J Franke | Physician Assistant | 1005 Pennsylvania Ave Ste 210, Ottumwa, IA 52501 | 2005-12-30 |
| 1427041359 | Wendy Sue Bittner | Physician Assistant | 1005 Penn Ave, Suite 204, Ottumwa, IA 52501-6413 | 2005-08-25 |
| 1477017663 | Emergency Services of Iowa LLC | Physician Assistant | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2019-01-22 |
| 1649704370 | Christina Noel Kelley | Physician Assistant | 920 N Quincy Ave, Ottumwa, IA 52501-3866 | 2017-04-19 |
| 1235410697 | Ottumwa Mental Wellness Center | Physician Assistant | 801 N Quincy Ave, Ottumwa, IA 52501-3869 | 2011-08-30 |
| 1124338926 | Wapello Emergency Group PC | Physician Assistant | 1001 Pennsylvania Ave, Ottumwa, IA 52501-6427 | 2010-10-14 |
| 1043220924 | Thomas H Hoskins | Physician Assistant | 1005 Pennsylvania Ave, Suite 212, Ottumwa, IA 52501-6413 | 2006-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679189971 | Amber Rae Rupiper | Physician Assistant | 518 Locus Street, Davenport, IA 52803 | 2020-09-22 |
| 1992311435 | Elli Kay Vore | Physician Assistant | 4327 129th St, Urbandale, IA 50323-2480 | 2020-09-21 |
| 1023624699 | Vivara Rages | Physician Assistant | 3054 Cherrywood Dr, Bettendorf, IA 52722-7550 | 2020-09-19 |
| 1598371270 | Samantha Delores Gartner | Physician Assistant | 518 W Locust St # 287, Davenport, IA 52803-2829 | 2020-09-18 |
| 1912521444 | Charles Bradley Walters | Physician Assistant | 201 S Clinton St # 168, Iowa City, IA 52240-4034 | 2020-06-01 |
| 1972124956 | Michaela J Maliszewski | Physician Assistant | 201 Ridge St Ste 302, Council Bluffs, IA 51503-4643 | 2020-05-01 |
| 1013544667 | Annie Penquite | Physician Assistant | 6001 Westown Pwky, West Des Moines, IA 50266 | 2020-03-24 |
| 1336774488 | Jakob J. Olson | Physician Assistant | 2751 Northgate Dr Ste 1, Iowa City, IA 52245-9509 | 2020-03-10 |
| 1215561006 | Paul David Kretkowski | Physician Assistant | 714 N Johnson St, Iowa City, IA 52245-2014 | 2020-03-02 |
| 1154962983 | Megan Wulf | Physician Assistant | 24141 80th Ave, Walcott, IA 52773-9737 | 2019-10-02 |
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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.