NPIMap

Individual provider Active NPI

Justin M Moore, MD

  • Family Medicine Physician
  • Anderson, SC
National Provider Identifier
1013178110
Registry record updated Feb 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
LL31007 Issued in SC
Practice address
4120 Highway 24
Anderson, SC 29626-5321
Phone
(864) 512-5830
Fax
(864) 224-4999
NPI assigned
Jun 20, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X LL31007 SC Primary

Addresses

Primary practice location

4120 Highway 24
Anderson, SC 29626-5321

Mailing address

PO Box 100174
Columbia, SC 29202-3174
Phone (864) 512-5830

Other identifiers 3

IdentifierTypeStateIssuer
003111684AMedicaidGA
310078MedicaidSC
P01170009OtherSCRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110111000587 SC Practitioner - Family Practice 1951590611 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of South Carolina School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Anmed HealthGroup PAC ID 1951215243, 348 clinicians

Practice addresses (Care Compare)

4120 Hwy 24
Anderson, SC 29626-5321
Phone (864) 224-4003

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.7 of 100Reported as apm
Quality
89.4
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
LL31007SCMDFamily Medicine Physician
31007SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Anmed Health Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Anmed Health Family Medicine Current Accepting new patients
Anmed Health Family Medicine CurrentSince Jul 1, 2011 Accepting new patients
Anmed Health Past Accepting new patients
Anmed Health Past Accepting new patients

Locations

4120 Highway 24
Anderson, SC 29626
Phone (864) 224-4003

800 N Fant St
Ste A
Anderson, SC 29621
Phone (864) 225-5131

1100 W Franklin St
Anderson, SC 29624
Phone (864) 224-0822

Networks

  • devoted network organization-92131eb0-09f2-4173-a140-cf7b381f0cf1

Interoperability endpoints

  • Direct secure messaging: jmoore8269@direct.anmedhealth.net

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676505600000",
    "number": "1013178110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100174",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292023174",
            "telephone_number": "864-512-5830",
            "fax_number": "864-224-4999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4120 HIGHWAY 24",
            "city": "ANDERSON",
            "state": "SC",
            "postal_code": "296265321",
            "telephone_number": "864-512-5830",
            "fax_number": "864-224-4999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JUSTIN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-20",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "LL31007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003111684A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "310078",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01170009",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Anderson, SC

Sources for this page

Verify at the official NPI Registry.