Angelia Renee' Moore, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

0110004893 Issued in VA

Practice address

6439 Iron Bridge Rd
North Chesterfield, VA 23234-5205

Phone

(804) 271-8990

NPI assigned

Mar 30, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Universal Health Corporation

  • Internal Medicine Physician
  • Roanoke, VA
  • NPI 1407117625
  Medicare reassignment

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1033504857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6439 IRON BRIDGE RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232345205",
            "telephone_number": "804-271-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6439 IRON BRIDGE RD",
            "city": "NORTH CHESTERFIELD",
            "state": "VA",
            "postal_code": "232345205",
            "telephone_number": "804-271-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELIA",
        "middle_name": "RENEE'",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110004893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krystal Patrice Montague
• Olga Montgomery, LCSW
• Taylor Moo-Young, PA-C
• George Moody, M.ED LPC
• Christina Mooradian, RD
• Floyd Alexander Moore III, PTA
• Mary Elizabeth Moore
• Miranda Moore, PHARMD
• Shaniqua Lashae Moore, LCSW
• Moorefield Park Endoscopy Center, LLC

• Medical Physician Assistant in North Chesterfield, VA
• Providers in North Chesterfield, VA by specialty
• Medical Physician Assistant in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.