Individual provider Active NPI

Allison Stoughton Moore, NP-C

  • Family Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1013369453
Registry record updated Jan 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
20293 Issued in SC
Practice address
126 S Assembly St
Columbia, SC 29201-4545
Phone
(803) 771-1342
NPI assigned
Jul 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 20293 SC Primary

Addresses

Primary practice location

126 S Assembly St
Columbia, SC 29201-4545

Mailing address

3709 Greenbriar Dr
Columbia, SC 29206-3323

Other identifiers 1

IdentifierTypeStateIssuer
4139MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170306001444 SC Practitioner - Nurse Practitioner 5991089286 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1228 Harden St
Suite B
Columbia, SC 29204-1800
Phone (803) 733-5969

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
20293SCMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Eau Claire Cooperative Health Center, Inc. CurrentSince Apr 9, 2017 Accepting new patients
Carolina Diabetes & Kidney Center, LLC CurrentSince Jan 1, 2017 Accepting new patients
Eau Claire Cooperative Health Center ,Inc. CurrentSince Apr 9, 2017 Accepting new patients

Locations

2117 Gervais St
Columbia, SC 29204
Phone (803) 744-0540

3800 N Main St
Ste B
Columbia, SC 29203
Phone (803) 705-3172

1228 Harden St
Columbia, SC 29204
Phone (803) 744-0540

1228 Harden St
Ste B
Columbia, SC 29204
Phone (803) 744-0540

4605 Monticello Rd
Columbia, SC 29203
Phone (803) 252-7001

625 W Wesmark Blvd
Sumter, SC 29150
Phone (803) 469-7950

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCAHAD
  • Direct secure messaging: allison.moore.1@10781.direct.athenahealth.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736467200000",
    "number": "1013369453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3709 GREENBRIAR DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292063323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 S ASSEMBLY ST",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292014545",
            "telephone_number": "803-771-1342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALLISON",
        "middle_name": "STOUGHTON",
        "name_prefix": "Dr.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-01-10",
        "certification_date": "2025-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "20293",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4139",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.