SHANE MOORE DPM PC (NPI# 1710470950) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710470950 |
| Entity Type | Organization |
| Organization Name | SHANE MOORE DPM PC |
| Practice Address |
13660 N 94th Dr Ste F1 Peoria AZ 85381-4232 |
| Practice Telephone | 6239740522 |
| Practice Fax Number | 6239335787 |
| Mailing Telephone | 6239740522 |
| Mailing Fax Number | 6239335787 |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2018-06-12 |
| Authorized Official Name | DR. STEVEN SHANE MOORE (OWNER) |
| Authorized Official Telephone | 4802419848 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
0802 | AZ | Podiatric Medicine & Surgery Service Providers |
| Street Address |
13660 N 94TH DR STE F1 |
| City | PEORIA |
| State | AZ |
| Zip Code | 85381-4232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699065839 | Keith Bangart Dpm PC | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2011-04-08 |
| 1710471529 | Jeff Thomas Pllc | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-06-15 |
| 1699276881 | Neo Matrix Anesthesia LLC | Anesthesiology | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-23 |
| 1154822369 | Regenerative Foot & Ankle LLC | Clinic/Center | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2018-02-22 |
| 1306101571 | Steven Shane Moore | Podiatrist | 13660 N 94th Dr Ste F1, Peoria, AZ 85381-4232 | 2012-07-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932712122 | Vicki L Grenier | Registered Nurse | 7558 W. Thunderbird Rd. Ste 1-507, Peoria, AZ 85381 | 2020-08-26 |
| 1568934107 | Earthwalk Wellness Group, LLC | Social Worker | 14050 North 83rd Avenue, Suite 290, Peoria, AZ 85381 | 2018-12-20 |
| 1316412059 | John & Biljana Feeley Dba J & B Assisted Living IIi Inc | Community Based Residential Treatment Facility, Mental Illness | 7331 W Sweetwater Avenue, Peoria, AZ 85381 | 2018-10-09 |
| 1467958611 | Arizona Community Pharmacy | Pharmacy | 14100 N 83rd Ave Ste 160, Peoria, AZ 85381 | 2018-04-04 |
| 1083112106 | Marissa Lynn Desjardins | Physical Therapist | 8240 W. Cactus Rd. Oakeson Physical Therapy, Peoria, AZ 85381 | 2018-01-23 |
| 1235651399 | Power Back Batteries LLC | Durable Medical Equipment & Medical Supplies | 9054 West Lisbon Ave, Peoria, AZ 85381 | 2017-07-11 |
| 1457897027 | Sonoran Sky Community Services | Community Based Residential Treatment Facility, Mental Illness | 7524 W. Alexandria Way, Peoria, AZ 85381 | 2017-01-06 |
| 1386023448 | Scott Boone | Registered Nurse | 7715 W Watson Ln, Peoria, AZ 85381 | 2015-05-22 |
| 1881084838 | Pinnacle Women's Center LLC | Obstetrics & Gynecology | 15396 N 83rd Ave Ste F100, Peoria, AZ 85381 | 2015-01-29 |
| 1245637081 | Kathi Locke | Counselor | 13460 N. 94th Drive, Suite J2, Peoria, AZ 85381 | 2014-11-21 |
| Find all providers in zip 85381 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407418395 | Jupiter Medical Services LLC | Podiatrist | 13660 N 94th Dr # D-1, Peoria, AZ 85381-4836 | 2019-07-01 |
| 1548615875 | Yehia Mohamed Elebrashi | Podiatrist | 10204 W Happy Valley Pkwy, Ste 160, Peoria, AZ 85383-2880 | 2016-04-23 |
| 1306118328 | Jeff Thomas | Podiatrist | 13660 N 94th Dr Ste D1, Peoria, AZ 85381-4836 | 2012-02-07 |
| 1750506846 | Illinois Valley Podiatry Group PC | Podiatrist | 3322 W Willow Knolls, Peoria, IL 61614 | 2007-04-16 |
| 1679620876 | Ernest A Nwani | Podiatrist | 409 N Western Ave, Peoria, IL 61606-1652 | 2007-01-03 |
| 1942270434 | Donald Joe Sheller | Podiatrist | 3827 N Prospect Rd, Peoria, IL 61616-7767 | 2006-01-25 |
| 1114926748 | Curtis L Ward | Podiatrist | 5017 N Glen Park Place Rd, Peoria, IL 61614-4677 | 2005-07-15 |
| 1831717891 | Saturn Medical Specialists, LLC | Podiatrist | 13660 N 94th Drive, Ste D-1, Peoria, AZ 85381-8538 | 2020-07-07 |
| 1417574328 | Ryan Bangart Dpm PC | Podiatrist | 13660 N 94th Dr Ste D1, Peoria, AZ 85381-4836 | 2020-06-26 |
| 1538798004 | Vitality Foot and Ankle Institute Pllc | Podiatrist | 10204 W Happy Valley Pkwy Ste 160, Peoria, AZ 85383-2880 | 2020-04-06 |
| Find all providers in PEORIA | ||||
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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.