Lisa Jo Moore, NP-C

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2020011705 Issued in MO

Practice address

3033 S Kansas Expy
Springfield, MO 65807-5969

Phone

(417) 881-7442

Fax

(417) 988-9844

NPI assigned

Oct 22, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa Jo Moore Professional name

Medicare fee-for-service enrollment

Enrolled in MO

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisa.moore@519132116156420.direct.elationemr.com

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.

• Phoenix Home Care, LLC

  • Nurse Practitioner
  • Springfield, MO
  • NPI 1841881869
  Medicare reassignment NPD
• Phoenix Home Care, LLC

  • Home Health Agency
  • Saint Louis, MO
  • NPI 1386057578
  NPD

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1033718903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "861 S DRY GULCH RD",
            "city": "NIXA",
            "state": "MO",
            "postal_code": "657146708",
            "telephone_number": "417-234-1026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3033 S KANSAS EXPY",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658075969",
            "telephone_number": "417-881-7442",
            "fax_number": "417-988-9844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "JO",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-22",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "2020011705",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2020011705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MOORE",
            "middle_name": "JO",
            "credential": "NP-C",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Devin B Moore, PA-C
• Heather Anne Moore, PMHNP-BC
• Josie Moore
• Laura Elisabeth Moore, DDS
• Linda L. Moore, M.S., CCC-SLP
• Malia K Moore
• Mallory Moore, CCC-SLP
• Melissa D. Moore, FNP-C
• Molly Cathryn Moore
• Natalie A Moore, PLPC

• Nurse Practitioner in Springfield, MO
• Providers in Springfield, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; 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.