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

Dr. John Russell Moore, MD

Individual provider Urology Physician · NPI 1114977550

Dr. John Russell Moore, MD is an Urology in Independence, Missouri. Qualified in 1996, 30 years ago. Practices with Advanced Urologic Associates Inc, a 14-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
30
Licensed in
MO
In the registry since
2006
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

19001 E 48th St S
Independence, MO 64055
Phone: (816) 836-8831
Fax: (816) 795-0144
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence 2001004851 (MO)

Record details

NPI number1114977550
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 10, 2006
Last updated in NPPESSeptember 21, 2014
Mailing address19001 E 48th St S, Independence, MO 64055

Medicare enrollment

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

Medicare specialtyUROLOGY
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Advanced Urologic Associates Inc — 14 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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