NPIMap

Individual provider Active NPI

Donna H Moore, NP-C

  • Primary Care Nurse Practitioner
  • Summersville, WV
National Provider Identifier
1073760864
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
48550 Issued in WV
Practice address
211 Merchants Walk
Summersville, WV 26651-1901
Phone
(304) 872-9455
NPI assigned
Aug 22, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 48550 WV
Primary Care Nurse Practitioner 363LP2300X 48550 WV Primary

Addresses

Primary practice location

211 Merchants Walk
Summersville, WV 26651-1901

Mailing address

PO Box 1049
Lewisburg, WV 24901-4049
Phone (304) 645-4043

Other identifiers 2

IdentifierTypeStateIssuer
0035222000MedicaidWV
48550OtherWVLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20090422000157 WV Practitioner - Nurse Practitioner 0941357396 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
West Virginia Health Care Cooperative IncGroup PAC ID 9830431030, shared by 3 NPIs, 61 clinicians

Practice addresses (Care Compare)

211 Merchants Walk
Summersville, WV 26651-1901
Phone (304) 872-9455

400 Fairview Heighs Rd
Summersville, WV 26651-9308

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
48550WVMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
West Virginia Health Care Cooperative Inc CurrentSince Nov 20, 2023 Accepting new patients
West Virginia Health Care Cooperative Inc Current Accepting new patients

Locations

400 Fairview Heights Rd
Summersville, WV 26651
Phone (304) 872-2891

211 Merchants Walk
Summersville, WV 26651
Phone (304) 645-0870

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1219363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1414713600000",
    "number": "1073760864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1049",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249014049",
            "telephone_number": "304-645-4043",
            "fax_number": "304-645-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 MERCHANTS WALK",
            "city": "SUMMERSVILLE",
            "state": "WV",
            "postal_code": "266511901",
            "telephone_number": "304-872-9455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "DONNA",
        "middle_name": "H",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-22",
        "last_updated": "2014-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "48550",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "WV",
            "license": "48550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035222000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "48550",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Summersville, WV

Sources for this page

Verify at the official NPI Registry.