Provider Demographics
NPI:1649481391
Name:MOORE, ANNE SCHOLL (MD)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:SCHOLL
Last Name:MOORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10272 E DEMOCRAT ROAD
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134
Mailing Address - Country:US
Mailing Address - Phone:720-236-5079
Mailing Address - Fax:303-805-0225
Practice Address - Street 1:13123 16TH AVE, NW
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045
Practice Address - Country:US
Practice Address - Phone:720-777-6004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35144365208000000X
MDD0093160208000000X, 208M00000X
NC2024-00312208000000X
OH35.144365208M00000X
CO21074208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01210749Medicaid
CO001293OtherKAISER-COMMERCIAL NUMBER
OH0475469Medicaid
CO001293OtherKAISER-COMMERCIAL NUMBER