Individual provider Active NPI

Casey Elizabeth Moore, RN, MSN, FNP-C

  • Family Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1013311075
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
9391375 Issued in AL
Practice address
1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2990
Phone
(205) 507-8930
NPI assigned
Oct 20, 2014
Sex
Female
Sole proprietor
Yes

Organizations & group practices 4

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

Hospital & facility affiliations 3

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

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Alabama Dept of Mental Health and Mental Retardation 13 clinicians

Practice addresses (Care Compare)

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2990
Phone (205) 507-8000

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
I20200811000568 AL Practitioner - Nurse Practitioner 0446472690 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
9391375ALMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
State of Alabama Dept of Mental Health & Mental Retardation Current Accepting new patients
State of Alabama Dept of Finace CurrentSince May 1, 2020 Accepting new patients
State of Alabama Dept of Mental Health & Mental Retardation CurrentSince May 1, 2020 Accepting new patients

Locations

200 University Blvd
Tuscaloosa, AL 35401
Phone (205) 759-0715

1301 Jack Warner Pkwy NE
Tuscaloosa, AL 35404
Phone (205) 462-4500

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404
Phone (205) 507-8000

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 9391375 AL Primary

Addresses

NPPES NPI Registry

Primary practice location

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2990

Mailing address

1651 Ruby Tyler Pkwy
Tuscaloosa, AL 35404-2990
Phone (205) 507-8930

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 6, 2024.

{
    "created_epoch": "1413763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1013311075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042990",
            "telephone_number": "205-507-8930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 RUBY TYLER PKWY",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354042990",
            "telephone_number": "205-507-8930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CASEY",
        "middle_name": "ELIZABETH",
        "credential": "RN, MSN, FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-20",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "9391375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.