MARY A MOORE (NPI# 1972598753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972598753 |
| Entity Type | Individual |
| Full Name | MARY A MOORE |
| Credential | NP |
| Practice Address |
215 Corporate Dr Suite B Beaver Dam WI 53916-3123 |
| Practice Telephone | 9203569415 |
| Practice Fax Number | 9203569477 |
| Mailing Telephone | 9203569415 |
| Mailing Fax Number | 9203569477 |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2015-11-12 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
1744-033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
1744- 033 | WI | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780215467 | Mary Major Moore | Massage Therapist | 335 Ne 4th St # Dt, Bend, OR 97701-5162 | 2020-01-30 |
| 1205205804 | Mary Rose Moore | Nurse Practitioner | 1443 Richmond Road, Lyndhurst, OH 44124 | 2015-09-24 |
| 1063654192 | Mary G Moore | Counselor | 103 William Dr, Normal, IL 61761-1862 | 2009-04-06 |
| 1588812325 | Mary Moore | Occupational Therapist | 6801 Copra Ln, Louisville, KY 40219-2156 | 2008-09-05 |
| 1275796625 | Mary Moore | Advanced Practice Midwife | 4118 Winnemac Ave, Madison, WI 53711-1645 | 2008-07-07 |
| 1023288123 | Mary Elizabeth Moore | Registered Nurse | 1064 Independence Ave, Akron, OH 44310 | 2008-03-04 |
| 1861672347 | Mary Patricia Moore | Psychiatry & Neurology | 280 Broad St Ste E, Kernersville, NC 27284-2948 | 2007-11-13 |
| 1134314263 | Mary Margaret Moore | Dermatology | 7435 Highway 6 Ste B, Missouri City, TX 77459-4698 | 2007-09-11 |
| 1871799957 | Mary E Moore | Psychologist | 325 W Hospitality Lane, Suite 310, San Bernandino, CA 92408-3212 | 2007-06-25 |
| 1578629309 | Mary A Moore | Social Worker | 19206 Huebner, Ste 104, San Antonio, TX 78258-9800 | 2006-12-28 |
| Street Address |
215 CORPORATE DR SUITE B |
| City | BEAVER DAM |
| State | WI |
| Zip Code | 53916-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154877504 | Paladina Health, LLC | Family Medicine | 215 Corporate Dr, Suite A, Beaver Dam, WI 53916-3123 | 2016-08-26 |
| 1205248804 | Ayaz Samandani Md Sc | Family Medicine | 215 Corporate Dr, Suite H, Beaver Dam, WI 53916-3123 | 2014-05-30 |
| 1396985636 | Ayaz M. Samadani, Md, Sc | Clinical Medical Laboratory | 215 Corporate Dr, Suite H, Beaver Dam, WI 53916-3123 | 2009-02-26 |
| 1609031186 | Marsha Gail Cannon | Registered Nurse | 215 Corporate Dr, Suite B, Beaver Dam, WI 53916-3123 | 2008-07-23 |
| 1992876734 | Thomas J Kalinosky Do | Family Medicine | 215 Corporate Dr, Suite G, Beaver Dam, WI 53916-3123 | 2006-11-13 |
| 1982719266 | Thomas J Kalinosky | Family Medicine | 215 Corporate Dr, Suite G, Beaver Dam, WI 53916-3123 | 2006-08-20 |
| 1992758254 | Madison Vamc | Clinic/Center | 215 Corporate Dr, Suite B, Beaver Dam, WI 53916-3123 | 2006-05-18 |
| 1811947088 | Ayaz M Samadani | General Practice | 215 Corporate Dr, Suite H, Beaver Dam, WI 53916-3123 | 2006-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538718283 | Paulette Neibauer | Technician | N7262 Farwell Rd., Beaver Dam, WI 53916 | 2019-09-05 |
| 1902336597 | Tricounty Homecare Inc | In Home Supportive Care | 140 Corporate Dr Ste 2, Beaver Dam, WI 53916 | 2017-06-15 |
| 1528502754 | Jessica Marie Blatz | Counselor | 809 Park Aveune, Beaver Dam, WI 53916 | 2016-12-07 |
| 1376090886 | Beaver Dam Hearing Care, LLC | Hearing Aid Equipment | 705 University Ave, Suite 170, Beaver Dam, WI 53916 | 2016-09-01 |
| 1275902546 | Beaver Dam Community Hospitals Inc | Pharmacy | 705 S University Ave Ste 180, Beaver Dam, WI 53916 | 2015-09-17 |
| 1609242825 | Tami Joe Delisle | Counselor | 207 North Spring Street, Beaver Dam, WI 53916 | 2015-08-12 |
| 1366833394 | Beaver Dam Community Hospitals, Inc | Surgery | 705 S University Ave Ste 350, Beaver Dam, WI 53916 | 2015-02-12 |
| 1326471608 | Raquel Rodriguez-guzman | Pharmacist | 205 La Crosse Street, Beaver Dam, WI 53916 | 2013-08-09 |
| 1558608828 | Mary Y Kunz | Licensed Practical Nurse | 6550 N Highway 151 Lot 63, Beaverdam, WI 53916 | 2013-01-07 |
| 1881938454 | Brock Holden Slinger | Physical Therapist | 205 Monroe St. #13, Beaver Dam, WI 53916 | 2012-11-20 |
| Find all providers in zip 53916 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609994789 | Bluegrass Regional Healthcare | Nurse Practitioner | 1307 N Main St, Beaver Dam, KY 42320-8957 | 2007-03-27 |
| 1700872009 | Cynthia R Wilson | Nurse Practitioner | 1313 N Main St, Beaver Dam, KY 42320-8957 | 2005-09-22 |
| 1922000736 | Susan B Matthews | Nurse Practitioner | 1621 N Main St, Beaver Dam, KY 42320-8963 | 2005-08-11 |
| 1316941701 | Mary Ann Chambers | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2005-06-13 |
| 1871067553 | Chris Alan Thomas II | Nurse Practitioner | 1701 N Spring St, Beaver Dam, WI 53916-1178 | 2019-01-16 |
| 1215457288 | Courtney Nicole Keller | Nurse Practitioner | 1213 N Main St, Beaver Dam, KY 42320-8955 | 2017-06-21 |
| 1972973865 | Alelea B. Hewitt | Nurse Practitioner | 1520 N Main St, Beaver Dam, KY 42320-8960 | 2015-10-05 |
| 1134530769 | Lisa Drew | Nurse Practitioner | 110 Monroe St, Beaver Dam, WI 53916-2437 | 2014-05-16 |
| 1659700375 | Jennifer Shepard | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2013-11-04 |
| 1730513243 | Dawn Debra Poull | Nurse Practitioner | 707 S University Ave, Beaver Dam, WI 53916-3027 | 2013-09-03 |
| Find all providers in BEAVER DAM | ||||
| City | BEAVER DAM |
| Zip Code | 53916 |
Please comment or provide details below to improve the information on MARY A MOORE.
| 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.