Look up the most recent NPI and PECOS records

Thomas Allen Moore

Family Medicine

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Thomas Allen Moore does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1285721795
Provider Type
Individual
Full Name
Moore, Thomas Allen
Title
Dr.
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
10/6/2006
Last Updated
7/9/2007

Contact Information

Practice Location

37 Varden Dr, Aiken, SC 29803-5297

(803) 644-7897

(803) 643-3026

Mailing Location

37 Varden Dr, Aiken, SC 29803-5297

(803) 644-7897

(803) 643-3026

Provider Taxonomies

Code	Description	License
Code 207Q00000X Primary	Description Family Medicine Allopathic & Osteopathic Physicians	License 19409 South Carolina

Provider Identifiers

ID	Description	Issuer
ID 194097	Description Medicaid	Issuer Unlisted South Carolina

Thomas Allen Moore

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Keigans, Mary Cade

Southside Family Medicine

Conlon, Alexander Michael

Zimmerman, David Wayne

Toomer, Catherine Harmon

Fallaw, Robyn F.

Bruckner, Adam W

Vaughters Family Practice Llc

Vaughters, Ray B.

Schwartz, Alan Christopher