Moore Emergency Group, LLC
Organization Active NPI Emergency Medicine Physician · Andalusia, AL
NPI 1013415769 · NPPES record last updated Mar 23, 2022
Key facts
- NPI
- 1013415769
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- Legal business name
- MOORE EMERGENCY GROUP, LLC
- Practice address
- 849 S Three Notch St
Andalusia, AL 36420-5325 - Phone
- (334) 222-8466
- NPI assigned
- Jan 29, 2018
- Organization subpart
- No
Authorized official
- Name
- Lisha C Falk
- Title
- VP of Contracting
- Phone
- (337) 609-1221
Practitioners 46
-
Jeffrey William Allman, D.O.
-
Roger T Boyington, D.O.
-
Jennifer Coker, CRNP
-
Andre H Doucet, M.D.
-
Mark Stephen Griffin, M.D.
-
Pamela Ingram, FNP-C
-
Matthew Lee, NP-C
-
Henry R Lemley, MD
-
Larry Mitchell, MD
-
Chigozie U. Obiaka, M.D.
-
Heath A. Parker, D.O.
-
Alzo Preyear, DO
-
Sara E Purvis, CRNP
-
Judieth Darlene Sims, FNP-BC, CRNP
-
Warren Glen Tyon, M.D.
-
William Scott Walters, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180403002099 | AL | Part B Supplier - Clinic/Group Practice | 9537421516 |
Receives reassigned benefits from 45 practitioners Practice locations: Andalusia, AL |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician |
207P00000X | Yes | ||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X |
Addresses
Primary practice location
849 S Three Notch St
Andalusia, AL 36420-5325
Mailing address
200 Corporate Blvd
Lafayette, LA 70508-3870
Phone (800) 893-9698
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0053 | Medicaid | AL |
Other providers in Andalusia, AL
- Milan Hair Collection
- Millard H. McWhorter III MD PC
- Dana Sabrina Mills
- Carrie Lou Mitchell
- Joan Mitchell
- Moore Physician Services, LLC
- MRI of Andalusia LLC
- Christina Mullen
- Steven Samuel Murrell
- Kristy Nelms
All providers in Andalusia, AL · Emergency Medicine Physician in Alabama
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.