Individual provider Active NPI

Amy Moore, CRNP

  • Acute Care Nurse Practitioner
  • Tuscaloosa, AL
National Provider Identifier
1013553197
Registry record updated Dec 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1-141476 Issued in AL
Practice address
100 Rice Mine Road Loop Ste 104
Tuscaloosa, AL 35406-2421
Phone
(205) 561-2370
Fax
(205) 345-4921
NPI assigned
Nov 22, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 5, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 1-141476 AL
Gerontology Nurse Practitioner 363LG0600X 1-141476 AL
Acute Care Nurse Practitioner 363LA2100X 1-141476 AL Primary

Addresses

Primary practice location

100 Rice Mine Road Loop Ste 104
Tuscaloosa, AL 35406-2421

Mailing address

100 Rice Mine Road Loop Ste 104
Tuscaloosa, AL 35406-2421
Phone (205) 561-2370

Other practice location 1

619 19th St S
Birmingham, AL 35233-1900
Phone (205) 934-4011

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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220301000430 AL Practitioner - Nurse Practitioner 6709270176 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Alabama Health Services Foundation, PCGroup PAC ID 1951213107, 2,784 clinicians

Practice addresses (Care Compare)

619 19TH St S
Birmingham, AL 35249-1900
Phone (205) 934-4011

Hospital & facility affiliations

  • University of Alabama Hospital Hospital, Birmingham, AL, CCN 010033

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1-141476ALMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bama Heart Doc, P.C. CurrentSince Apr 1, 2022 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Dec 1, 2024 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1802 6th Ave S
Fl 5
Birmingham, AL 35233
Phone (205) 996-9485

100 Rice Mine Road Loop
Ste 104
Tuscaloosa, AL 35406
Phone (205) 342-2552

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BFCHBA

Organizations & group practices 2

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1574380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1013553197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP STE 104",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062421",
            "telephone_number": "205-561-2370",
            "fax_number": "205-345-4921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 RICE MINE ROAD LOOP STE 104",
            "city": "TUSCALOOSA",
            "state": "AL",
            "postal_code": "354062421",
            "telephone_number": "205-561-2370",
            "fax_number": "205-345-4921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "619 19th St S",
            "address_purpose": "LOCATION",
            "city": "Birmingham",
            "state": "AL",
            "postal_code": "352331900",
            "country_code": "US",
            "telephone_number": "205-934-4011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "AMY",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-11-22",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AL",
            "license": "1-141476",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-141476",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-141476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tuscaloosa, AL

Sources for this page

Verify at the official NPI Registry.