Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Colleen Johnson Moore, MD

Individual provider Vascular Surgery Physician · NPI 1801877923

Colleen Johnson Moore, MD is a Vascular Surgery in Cape Girardeau, Missouri. Graduated from University of Missouri, Kansas City, School of Medicine in 1996, 30 years ago. Accepts Medicare assignment. Licensed in Illinois and Missouri.

Years since qualifying
30
Trained at
University of Missouri, Kansas City, School of Medicine
Licensed in
IL, MO
In the registry since
2005
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

21 Doctors Park Ste A
Cape Girardeau, MO 63703-4927
Phone: (217) 788-0706
Fax: (217) 525-2535
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Vascular Surgery Physician (primary) Taxonomy 2086S0129X · Licence 036113689 (IL)
Vascular Surgery Physician Taxonomy 2086S0129X · Licence 2004001641 (MO)

Record details

NPI number1801877923
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 7, 2005
Last updated in NPPESJuly 27, 2023
Certification dateJuly 27, 2023
Mailing address21 Doctors Park Ste A, Cape Girardeau, MO 63703-4927

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyVASCULAR SURGERY
Also practisesGENERAL SURGERY
Medical schoolUNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduated 1996 (30 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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