Individual provider Active NPI

Clayton Moore, DO, PHARM.D, PA-C

  • Emergency Medicine Physician
  • Newport News, VA
National Provider Identifier
1073938577
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0010-07792 Issued in NC
Practice address
500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone
(757) 594-2000
NPI assigned
Feb 20, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 22426 NC
Medical Physician Assistant 363AM0700X 0010-07792 NC
Emergency Medicine Physician 207P00000X 0010-07792 NC Primary

Addresses

Primary practice location

500 J Clyde Morris Blvd
Newport News, VA 23601-1929

Mailing address

500 J Clyde Morris Blvd
Newport News, VA 23601-1929
Phone (757) 594-2000

Other practice location 1

4800 S Croatan Hwy
Nags Head, NC 27959-9704
Phone (252) 449-5600

Other practice location 2

111 Hospital Dr
Tarboro, NC 27886-2011
Phone (252) 641-7700

Other identifiers 3

IdentifierTypeStateIssuer
222426OtherNCNC STATE LICENSE NUMBER- PHARMACY
0010-07792OtherNCNC PA LICENSE NUMBER
0116040824OtherVAVIRGINIA INTERN/RESIDENT LICENSE

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cmoore237063@direct.vidanthealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20180313000442 NC Practitioner - Physician Assistant 6204198120 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
96.95 of 100Reported as apm
Quality
82.44
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22426NCMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Banks Professional Services, LLC CurrentSince Aug 3, 2018 Accepting new patients
Vidant Medical Group LLC CurrentSince Jan 1, 2018 Accepting new patients

Locations

2100 Stantonsburg Rd
Greenville, NC 27834
Phone (252) 744-3229

401 N Main St
Kenansville, NC 28349
Phone (910) 296-0941

4800 S Croatan Hwy
Nags Head, NC 27959
Phone (252) 449-4500

5565 N Croatan Hwy
Southrn Shore, NC 27949
Phone (252) 261-5800

111 Hospital Dr
Tarboro, NC 27886
Phone (252) 641-7700

Interoperability endpoints

  • Direct secure messaging: cmoore237063@direct.vidanthealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1392854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1073938577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 J CLYDE MORRIS BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236011929",
            "telephone_number": "757-594-2000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 S Croatan Hwy",
            "address_purpose": "LOCATION",
            "city": "Nags Head",
            "state": "NC",
            "postal_code": "279599704",
            "country_code": "US",
            "telephone_number": "252-449-5600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 Hospital Dr",
            "address_purpose": "LOCATION",
            "city": "Tarboro",
            "state": "NC",
            "postal_code": "278862011",
            "country_code": "US",
            "telephone_number": "252-641-7700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "DO, PHARM.D, PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-20",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NC",
            "license": "22426",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "0010-07792",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "0010-07792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC STATE LICENSE NUMBER- PHARMACY",
            "identifier": "222426",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NC PA LICENSE NUMBER",
            "identifier": "0010-07792",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VIRGINIA INTERN/RESIDENT LICENSE",
            "identifier": "0116040824",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoore237063@direct.vidanthealth.com",
            "affiliation": "N",
            "endpointDescription": "Vidant Health",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2100 Stantonsburg Rd",
            "city": "Greenville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "278342818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.