DR. AUBREY LEE III MOORE (PH.D.) – Psychologist, NPI 1093708737

DR. AUBREY LEE III MOORE (PH.D.) is a healthcare provider. based in Evans, Georgia. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PH.D.. They hold a License No. PSY002012 (GA). The NPI Number for DR. AUBREY LEE III MOORE (PH.D.) is 1093708737

Main info

Male
Sole Proprietor
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. AUBREY LEE III MOORE (PH.D.)
NPI
1093708737
Phone
(706) 284-1054
Address
320 GARDENIA DR
Enumeration Date
29 August 2005
Last Update Date
25 August 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7067299595
Graduation Year
1995 (31 years ago)
PAC ID
1052509973
Group Practice PAC ID
0244497378
Professional Enrollment ID
I20101220000584
Address ID
GA309094507AU3643XEXTE400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

482 CLINICAL PSYCHOLOGIST in GA

Provider Addresses for DR. AUBREY LEE III MOORE (PH.D.)

  • 320 GARDENIA DR

    EVANS, GA 308098239

    Phone: (706) 284-1054

    Fax: (706) 729-0332

    Type: Mailing

  • 3643 WALTON WAY EXT

    AUGUSTA, GA 309094507

    Phone: (706) 729-9595

    Fax: (706) 729-0332

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-12-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20101220000584IClinical PsychologistGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30809)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0244497378View full group profile
NameSpecialtyState
Clinical PsychologistGA
Clinical PsychologistGA
Clinical PsychologistGA

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Frequently asked questions

Can I verify DR. AUBREY LEE III MOORE (PH.D.) with an NPI only?
You can start verification with NPI 1093708737 for DR. AUBREY LEE III MOORE (PH.D.), then check state licensing separately.
Is DR. AUBREY LEE III MOORE (PH.D.) listed as active for patients and plans?
The listing shows DR. AUBREY LEE III MOORE (PH.D.) as active in the NPI system.
What healthcare role does DR. AUBREY LEE III MOORE (PH.D.) hold?
Scheduling teams often label DR. AUBREY LEE III MOORE (PH.D.) under Psychologist. Clinical services aligned with this taxonomy classification.
Does DR. AUBREY LEE III MOORE (PH.D.) list a practice location?
Patients near Evans, Georgia may find DR. AUBREY LEE III MOORE (PH.D.) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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