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Deactivated NPI 1336121276 Deactivated / Inactive NPI Male Practitioner

Dr. John H Moran , MD

Pediatrics • Providence, RI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. John Moran has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 16, 2005
NPI Deactivation Date June 21, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. John Moran, MD was a registered Pediatrics practicing in Providence, RI. Throughout an active medical career spanning 16 years, Dr. Moran provided care at the practice location at 202 PRAIRIE AVE until profile deactivation on 2021-06-21.

Practice Location & Contact Primary Location

Practice Address

202 Prairie Ave

Providence, RI 029052333

Telephone 4014440570
Fax 4014440427
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Providence, RI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.3 Yrs
State Avg: 17.6 Yrs
Regional Practice Density
165 Specialists

Practicing in Providence, RI (340 Statewide)

Telehealth Adoption Rate
0.6% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License RI MD4571

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
NPI 1003432212

Doctor of Medicine (M.D.)

NPI 1023472263

Master of Science

NPI 1053152678

Doctor of Dental Surgery

NPI 1063116416

Doctor of Medicine (M.D.)

Dr. Sumi Singh , MD

Internal Medicine

NPI 1073217865

Doctor of Medicine (M.D.)

Andrew Leukhardt , RN, CDOE

Registered Nurse - Diabetes Educator

NPI 1083449169

Registered Nurse, CDOE

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

12 Historical Events
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NPI Profile Deactivated June 21, 2021

Record deactivated on June 21, 2021

NPI Profile Active January 30, 2017

NPI status registered as active in NPPES database

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Updated Practice Location January 30, 2017

Registered at 40 CANDACE ST, PROVIDENCE, RI 029083747 (Tel: 4014440550)

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Updated Business Mailing Address January 30, 2017

Registered at 375 ALLENS AVE, PROVIDENCE, RI 029055010 (Tel: 4014440400)

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Provider Name / Credentials Updated January 30, 2017

Recorded as JOHN MORAN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 30, 2017

Pediatrics (License #MD4571 in RI)

NPI Profile Active August 29, 2007

NPI status registered as active in NPPES database

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Updated Practice Location August 29, 2007

Registered at 202 PRAIRIE AVE, PROVIDENCE, RI 029052333 (Tel: 4014440570)

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Updated Business Mailing Address August 29, 2007

Registered at 375 ALLENS AVE, PROVIDENCE, RI 029055010 (Tel: 4014440400)

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Provider Name / Credentials Updated August 29, 2007

Recorded as JOHN MORAN, MD

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Medical Taxonomy / Specialty Registered (Primary Specialty) August 29, 2007

Pediatrics (License #MD4571 in RI)

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Initial NPI Registration & Enumeration November 16, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336121276
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2005
Last Update: August 29, 2007
Deactivation Date: June 21, 2021

Mailing Address

375 Allens Ave

Providence, RI 029055010

Phone: 4014440400

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.