LISA M MOORE (NPI# 1659456630) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659456630 |
| Entity Type | Individual |
| Full Name | LISA M MOORE |
| Credential | PA-C |
| Practice Address |
690 Minot Ave Ste 1 Auburn ME 04210-3922 |
| Mailing Address |
324 Gannett Dr Ste 200 South Portland ME 04106-3266 |
| Practice Telephone | 2077831328 |
| Practice Fax Number | 2077864332 |
| Mailing Telephone | 2074827800 |
| Mailing Fax Number | 2074827898 |
| Enumeration Date | 2006-10-26 |
| Last Update Date | 2020-11-06 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA1497 | ME | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 9108417 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
800 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 1659456630 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Essex Center Dr, Peabody, MA 019602901 | 9785384267 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033718903 | Lisa Jo Moore | Nurse Practitioner | 2623 S Main Street, Nixa, MO 64804 | 2020-10-22 |
| 1114525813 | Lisa Michelle Moore | Homemaker | 2541 Rockcastle Ct, Miamisburg, OH 45342-7259 | 2020-10-14 |
| 1851913693 | Lisa Moore | Home Health Aide | 2208 Perry Ave, Edgewood, MD 21040-2806 | 2020-05-14 |
| 1275099954 | Lisa Moore | Nurse Practitioner | 6 Misty Glen Ct, Irmo, SC 29063-8134 | 2019-02-18 |
| 1336643410 | Lisa Marcella Moore | Nurse Practitioner | 500 W. Votaw Street, Portland, IN 47371 | 2018-03-22 |
| 1831628494 | Lisa Moore | Counselor | 2714 Tupelo St, Lake Charles, LA 70601-7376 | 2017-06-07 |
| 1801348818 | Lisa Moore | Specialist | 2147 Skyview Dr, Fayetteville, NC 28304-5126 | 2016-10-26 |
| 1679955801 | Lisa Moore | Nurse Anesthetist, Certified Registered | 1481 Meads, Orange, CA 92869 | 2015-06-24 |
| 1689068751 | Lisa Moore | Registered Nurse | 748 Addington Dr, Winterville, NC 28590-7102 | 2015-03-26 |
| 1700292190 | Lisa Moore | Nurse's Aide | 2765 Bramblebush Ct, Columbus, OH 43224-2505 | 2014-07-07 |
| Street Address |
690 MINOT AVE STE 1 |
| City | AUBURN |
| State | ME |
| Zip Code | 04210-3922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003818923 | Bhavagan S Maganti | Anesthesiology | 690 Minot Ave Ste 1, Auburn, ME 04210-3922 | 2005-08-11 |
| 1649754078 | Shields Imaging With Central Maine Health LLC | Clinic/Center | 690 Minot Ave Ste 1, Auburn, ME 04210-3922 | 2018-09-21 |
| 1376897967 | James Anthony Bois | Registered Nurse | 690 Minot Ave Ste 1, Central Maine Orthopaedics, P.a., Auburn, ME 04210-3922 | 2012-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538632245 | Matthew Charles Dove | Specialist/Technologist | 30 Belgrade Ave, Suite A, Auburn, ME 04210 | 2019-01-04 |
| 1851880603 | Dba Central Maine Conditioning Clinic | Massage Therapist | 30 Belgrade Ave Suite A, Auburn, ME 04210 | 2018-05-08 |
| 1285189654 | Kimberly Ann Boutwell | Nurse Practitioner | 15 Gracelawn Road, Auburn, ME 04210 | 2016-08-16 |
| 1487036554 | Eric Morrow | Specialist/Technologist | 36 Belgrade Ave, Auburn, ME 04210 | 2015-06-24 |
| 1750770152 | Larissa J Brown | Marriage & Family Therapist | 86 Main Sreet, Suite 302, Auburn, ME 04210 | 2015-01-22 |
| 1659771046 | Daniel Fontaine | Pharmacist | 689 Minot Ave., Auburn, ME 04210 | 2014-09-04 |
| 1104236793 | Caitlin White | Occupational Therapist | 415 Rodman Road, Auburn, ME 04210 | 2014-05-05 |
| 1780954883 | Richard Marc Pelletier | Counselor | 24 Dunn Street, Auburn, ME 04210 | 2012-01-05 |
| 1285929026 | Cynthia Morgan | Social Worker | 60 Court St., Auburn, ME 04210 | 2011-06-09 |
| 1972811164 | Wendy Thomas-blais | Social Worker | 229 Center St 2, Auburn, ME 04210 | 2010-09-22 |
| Find all providers in zip 04210 | ||||
| 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 |
|---|---|---|---|---|
| 1760009724 | Brenna Rasmussen | Physician Assistant | 88 Elmwood Rd, Auburn, ME 04210-6510 | 2020-06-25 |
| 1891235800 | Dekalb Health Memorial Hosptial Inc | Physician Assistant | 916 W. Seventh St., Auburn, IN 46706-2013 | 2017-02-24 |
| 1043671605 | Stefanie Morgan Wozmak | Physician Assistant | 137 Mcevoy Dr, Auburn, NH 03032-3930 | 2016-03-10 |
| 1063838258 | Robert Bogdasarian | Physician Assistant | 460 Southbridge St, Auburn, MA 01501-2442 | 2014-03-12 |
| 1801938394 | Kelli Knox Riddle | Physician Assistant | 1543 Professional Pkwy, Auburn, AL 36830-2858 | 2007-02-13 |
| 1801995618 | Thomas E Burkert | Physician Assistant | 77 Nelson Street, Suite 320, Amms, PC, Auburn, NY 13021 | 2006-09-21 |
| 1285746057 | Patrick Raymond Decommer | Physician Assistant | 3227 Professional Dr, Suite A, Auburn, CA 95602-2414 | 2006-08-31 |
| 1316987092 | Kara Lynn Perez | Physician Assistant | 310 6th St Ne, Auburn, WA 98002-4342 | 2006-06-08 |
| 1518912187 | Delinah M Anderson | Physician Assistant | 120 E Midland Rd, Auburn, MI 48611-9780 | 2006-05-23 |
| 1255391793 | Mark Henry Leinwand | Physician Assistant | 13 North Fulton Street, Auburn, NY 13021 | 2006-03-27 |
| Find all providers in AUBURN | ||||
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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.