MEDICARE: SHAWN THOMAS MOORE DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207Q00000X	Family Medicine Physician	02005910B	IN

General Provider Information

NPI Number	:	1861920977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHAWN THOMAS MOORE DO

Provider Business Mailing Address
First Line	:	1 MEMORIAL SQ STE 50
Second Line	:
City	:	GREENFIELD
State	:	IN
Zip	:	46140-1357
Country	:	US
Telephone Number	:	317-468-6257
Fax Number	:	317-468-6268

Provider Business Practice Location Address
First Line	:	7375 W US 52
Second Line	:
City	:	NEW PALESTINE
State	:	IN
Zip	:	46163-8950
Country	:	US
Telephone Number	:	317-861-4171
Fax Number	:	317-861-5325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/02/2017
Last Update Date	:	06/30/2020

Similar Medicare Providers

1750057519 — CHELSEA DRUMM
Practice Location Address:

7375 W US 52
NEW PALESTINE, IN
46163-8950

Practice Phone: 888-877-7222
Practice Fax: 833-888-0492

1689363988 — YAKISHA BLANC
Practice Location Address:

7375 W US 52
NEW PALESTINE, IN
46163-8950

Practice Phone: 888-877-7222
Practice Fax:

1740282201 — DR. ELIZABETH A BLACHLY M.D.
Practice Location Address:

7375 W US HIGHWAY 52
NEW PALESTINE, IN
46163-8950

Practice Phone: 317-861-4171
Practice Fax: 317-861-5325

1710971734 — DR. KRISTIN S BAGLEY M.D.
Practice Location Address:

7375 W. US 52 , NEW PALESTINE FAMILY MEDICINE
NEW PALESTINE, IN
46163-8950

Practice Phone: 317-861-4171
Practice Fax: 317-861-5325

1568708840 — MRS. ANGELA LOU SEAL MOT, OTR
Practice Location Address:

7375 W US 52
NEW PALESTINE, IN
46163-8950

Practice Phone: 888-877-7222
Practice Fax:

1316370638 — AMY SCHMOLL DIERSING FNP
Practice Location Address:

7375 W US 52
NEW PALESTINE, IN
46163-8950

Practice Phone: 317-861-4171
Practice Fax: 317-861-5325

Directions to “ SHAWN THOMAS MOORE DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.