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

Shane Edward Moore, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1982224796

Shane Edward Moore, DO is a General Surgery in Prescott Valley, Arizona. Graduated from At Still University of Health Sciences, College of Osteo Med, Kirksville in 2020, 6 years ago. Practices with Yavapai Regional Medical Center Physician Care LLC, a 119-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
6
Trained at
At Still University of Health Sciences, College of Osteo Med, Kirksville
Licensed in
AZ
In the registry since
2020
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Prescott Valley, AZ

No coordinates on file. Search this address in Google Maps

Additional practice locations (2)

  • 1301 S Crismon Rd, Mesa, AZ 85209-3767 — (480) 358-6450
  • 1001 Willow Creek Rd Ste 1200, Prescott, AZ 86301-1614 — (928) 458-2995

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 011620 (AZ)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1982224796
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedApril 22, 2020
Last updated in NPPESJune 3, 2025
Certification dateJune 3, 2025

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolAT STILL UNIVERSITY OF HEALTH SCIENCES, COLLEGE OF OSTEO MED, KIRKSVILLE
Graduated 2020 (6 years in practice)
Group practice Yavapai Regional Medical Center Physician Care Llc — 119 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Prescott Valley