Active NPI
James F Moore, CRNA
- Certified Registered Nurse Anesthetist
- Cookeville, TN
National Provider Identifier
1073503801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 8966
- Practice address
- 100 W 4TH St
Suite 310
Cookeville, TN 38501-2448 - Phone
- (931) 528-7877
- Fax
- (931) 526-3261
- NPI assigned
- Oct 24, 2005
- Last updated
- Jul 13, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | 8966 | TN | Primary |
Addresses
Primary practice location
100 W 4TH St
Suite 310
Cookeville, TN 38501-2448
Mailing address
100 W 4TH St
Suite 310
Cookeville, TN 38501-2448
Phone (931) 528-7877
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3602243 | Medicaid | TN | |
| 3050226 | Other | TN | BLUE CROSS BLUE SHIELD |
| 430035974 | Other | TN | MEDICARE RAILROAD |
| 74320946 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8966 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1073503801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 W 4TH ST",
"address_2": "SUITE 310",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012448",
"telephone_number": "931-528-7877",
"fax_number": "931-526-3261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 W 4TH ST",
"address_2": "SUITE 310",
"city": "COOKEVILLE",
"state": "TN",
"postal_code": "385012448",
"telephone_number": "931-528-7877",
"fax_number": "931-526-3261"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "JAMES",
"middle_name": "F",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-24",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "TN",
"license": "8966",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3602243",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "3050226",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "430035974",
"state": "TN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "74320946",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Cookeville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.