NPIMap

Individual provider Active NPI

Lori A Moyers, DO

  • Family Medicine Physician
  • Cape Girardeau, MO
National Provider Identifier
1023145125
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
115256 Issued in MO
Practice address
3129 Blattner Dr
Cape Girardeau, MO 63703-6364
Phone
(573) 335-0166
Fax
(573) 335-7942
NPI assigned
Feb 27, 2007
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 115256 MO Primary

Addresses

Primary practice location

3129 Blattner Dr
Cape Girardeau, MO 63703-6364

Mailing address

3129 Blattner Dr
Cape Girardeau, MO 63703-6364
Phone (573) 335-0166

Other identifiers 2

IdentifierTypeStateIssuer
DA4814OtherMORAILROAD MEDICARE
245290408MedicaidMO

Other names 1

  • Lori A Ferguson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20100901000070 MO Practitioner - Family Practice 4385716034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Kansas City College of Medicine and Surgery, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Health Facilities Rehab Services IncGroup PAC ID 3476679226, 152 clinicians
Riverside Family Medicine PCGroup PAC ID 7012189715, 4 clinicians

Practice addresses (Care Compare)

1102 Sikes Ave
Sikeston, MO 63801-5021

3129 Blattner Dr
Cape Girardeau, MO 63703-6364
Phone (573) 335-0166

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.93 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
83.1

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions15
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
115256MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Family Practice, PC Family Medicine Current Accepting new patients
Riverside Family Medicine PC Family Medicine CurrentSince Oct 18, 2017 Accepting new patients
Southeast Hospital Past Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

3129 Blattner Dr
Cpe Girardeau, MO 63703
Phone (573) 335-0166

Interoperability endpoints

  • Direct secure messaging: riversidefamilymedicinepc.loriamoyers@143636.advancedmd-direct.com

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 10

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": "1172534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1023145125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 BLATTNER DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036364",
            "telephone_number": "573-335-0166",
            "fax_number": "573-335-7942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3129 BLATTNER DR",
            "city": "CAPE GIRARDEAU",
            "state": "MO",
            "postal_code": "637036364",
            "telephone_number": "573-335-0166",
            "fax_number": "573-335-7942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYERS",
        "first_name": "LORI",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-27",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "115256",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA4814",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "245290408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LORI",
            "last_name": "FERGUSON",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cape Girardeau, MO

Sources for this page

Verify at the official NPI Registry.