Individual provider Active NPI

Corey Scott Moore, MD

  • Emergency Medicine Physician
  • Richmond, VA
National Provider Identifier
1104455385
Registry record updated Oct 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
0101278509 Issued in VA
Practice address
1250 E Marshall St
Richmond, VA 23298-5023
Phone
(804) 828-0996
NPI assigned
Apr 8, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 2022-03206 NC
Emergency Medicine Physician 207P00000X 0101278509 VA Primary

Addresses

Primary practice location

1250 E Marshall St
Richmond, VA 23298-5023

Mailing address

PO Box 780125
Philadelphia, PA 19178-0125
Phone (804) 922-4844

Other practice location 1

2495 Pocahontas Trl
Quinton, VA 23141-1637
Phone (804) 932-5500

Other practice location 2

618 Hospital Rd
Tappahannock, VA 22560-5000
Phone (804) 443-6297

Other practice location 3

300 Mt Clement Park Ste A
Tappahannock, VA 22560-5098
Phone (804) 443-8610

Other practice location 4

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 744-4757

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC, VA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230308001265 NC Practitioner - Emergency Medicine 2860813797 Reassigns benefits to 3 organizations
I20230912002351 VA Practitioner - Emergency Medicine 2860813797

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
JC Edwards School of Medicine, Marshall University, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Carolina UniversityGroup PAC ID 0244143246, 499 clinicians
Vidant Medical Group LLCGroup PAC ID 0345343893, 986 clinicians

Practice addresses (Care Compare)

2100 Stantonsburg Rd
Greenville, NC 27834-2818
Phone (252) 209-3000

500 S Academy St
Vidant Roanoke Chowan Hospital
Ahoskie, NC 27910-3261
Phone (252) 209-3360

Hospital & facility affiliations

  • Ecu Health Medical Center Hospital, Greenville, NC, CCN 340040
  • Ecu Health Bertie Hospital Hospital, Windsor, NC, CCN 341304

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

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

Merit-based Incentive Payment System (MIPS)

Final score
83.95 of 100Reported as group
Quality
69.91
Promoting interoperability
99
Improvement activities
40
Cost
77.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
0101278509VAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University Emergency Medicine CurrentSince Jul 1, 2023 Accepting new patients
Vidant Medical Group LLC CurrentSince Feb 27, 2023 Accepting new patients
East Carolina Health-Bertie Emergency Medicine CurrentSince Apr 26, 2023 Accepting new patients
East Carolina University Current Accepting new patients
East Carolina Health-Bertie CurrentSince Apr 26, 2023 Accepting new patients

Locations

500 Academy St S
Ahoskie, NC 27910
Phone (252) 209-3000

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

600 Moye Blvd
Greenville, NC 27834
Phone (252) 744-1111

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

1403 S King St
Windsor, NC 27983
Phone (252) 794-6685

Organizations & group practices 5

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 3

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

NPI Registry JSON

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

{
    "created_epoch": "1586304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761091200000",
    "number": "1104455385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 780125",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191780125",
            "telephone_number": "804-922-4844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E MARSHALL ST",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "232985023",
            "telephone_number": "804-828-0996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2495 Pocahontas Trl",
            "address_purpose": "LOCATION",
            "city": "Quinton",
            "state": "VA",
            "postal_code": "231411637",
            "country_code": "US",
            "telephone_number": "804-932-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "618 Hospital Rd",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605000",
            "country_code": "US",
            "telephone_number": "804-443-6297",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Mt Clement Park Ste A",
            "address_purpose": "LOCATION",
            "city": "Tappahannock",
            "state": "VA",
            "postal_code": "225605098",
            "country_code": "US",
            "telephone_number": "804-443-8610",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Stantonsburg Rd",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "NC",
            "postal_code": "278342818",
            "country_code": "US",
            "telephone_number": "252-744-4757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "COREY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-08",
        "last_updated": "2025-10-22",
        "certification_date": "2025-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NC",
            "license": "2022-03206",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VA",
            "license": "0101278509",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, VA

Sources for this page

Verify at the official NPI Registry.