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

Michael D Moore

Individual provider Family Nurse Practitioner · NPI 1851140149

Michael D Moore is a Nurse Practitioner in West Jordan, Utah. Qualified in 2023, 3 years ago. Practices with Mountainstar Medical Group-St Marks Hospital LLC, a 13-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
3
Licensed in
UT
In the registry since
2024
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Practice location Address checks out

8846 S Redwood Rd Ste E121
West Jordan, UT 84088-9366
Phone: (801) 569-1999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 11004975-4405 (UT)

Record details

NPI number1851140149
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMay 17, 2024
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025
Mailing addressPo Box 198560, Atlanta, GA 30384-8560

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Mountainstar Medical Group-St. Marks Hospital Llc — 13 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in West Jordan