Charles R Moore (NPI# 1801058821, PAC ID# 2769535574) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is UROLOGY.
| Nation Provider ID (NPI) | 1801058821 |
| PAC ID by PECOS | 2769535574 |
| Professional Enrollment ID | I20090727000543 |
| Full Name | Charles R Moore |
| Organization Legal Name | SOUTHERN UROLOGY, P. A. |
| Address |
139 Fairfield Dr Hattiesburg MS 39402-1303 |
| Phone Number | 6014502401 |
| Gender | M |
| Medical School | LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS |
| Graduation Year | 2003 |
| Primary Specialty | UROLOGY |
| Group Practice PAC ID | 0042287575 |
| Number of Group Practice Members | 5 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 250094 | MERIT HEALTH WESLEY |
| 250078 | FORREST GENERAL HOSPITAL |
| 251325 | COVINGTON COUNTY HOSPITAL CAH |
| 251303 | STONE COUNTY HOSPITAL |
| 250048 | ST DOMINIC-JACKSON MEMORIAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 139 Fairfield Dr, Hattiesburg, MS 39402-1303 | 6014502401 | SOUTHERN UROLOGY, P. A. |
| 5001 Hardy St, Hattiesburg, MS 39402-1308 | 6012688155 | WESLEY PHYSICIAN SERVICES LLC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_EP_1 | e-Prescribing | 72% | |
| ACI_EC_TRANS_MR_1 | Medication Reconciliation | 100% | |
| ACI_EC_TRANS_PEA_1 | Provide Patient Access | 91% | |
| ACI_EC_TRANS_PEA_2 | View, Download, or Transmit (VDT) | 18% | |
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % | |
| ACI_EC_TRANS_PSE_1 | Patient-Specific Education | 63% | |
| ACI_EC_TRANS_SM_1 | Secure Messaging | 13% |
| Organization Legal Name | SOUTHERN UROLOGY, P. A. |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hal T Liddell | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Nathan P Shappley | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Carey L Norris | Nurse Practitioner | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Deborah Tarpley Azar | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Street Address |
139 FAIRFIELD DR |
| City | HATTIESBURG |
| State | MS |
| Zip | 39402-1303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Hal T Liddell | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Nathan P Shappley | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Farren A Windham | Certified Registered Nurse Anesthetist (crna) | Southern Anesthesia Inc | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Kristen Reeves Ingram | Nurse Practitioner | Southern Surgical Associates, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Carey L Norris | Nurse Practitioner | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Deborah Tarpley Azar | Urology | Southern Urology, P. A. | 139 Fairfield Dr, Hattiesburg, MS 39402-1303 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| William T Cochran | Physical Therapy | 98 Place Blvd, Suite 52, Hattiesburg, MS 39402 | |
| Paul E Zeagler | Physical Therapy | Hattieburg Physical Therapy Center | 98 Place Blvd, Suite 52, Hattiesburg, MS 39402 |
| Jennifer Stewart | Physical Therapy | Drayer Physical Therapy Institute LLC | 6134 Hwy 98 W, Hattiesburg, MS 39402 |
| Paul M Rocconi | Diagnostic Radiology | Comprehensive Radiology Services, Pllc | 5000 W 4th St, Hattiesburg, MS 39402-1000 |
| Volney E Pierce Jr. | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Delia A Smith | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Barbara J Proctor | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Brenda Jordan | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Lynda I Gentchev | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Donald H Gale | Pathology | Hub Care Pathology, P.a. | 5052 W 4th St, Hattiesburg, MS 39402-1069 |
| Find all physicians in zip 39402 | |||
| City | HATTIESBURG |
| Zip Code | 39402 |
| Specialty | UROLOGY |
| City + Specialty | HATTIESBURG + UROLOGY |
Please comment or provide details below to improve the information on Charles R Moore.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.