Individual provider Active NPI

Sharon Wyatt Moore, MD, MBA, MPH

  • Public Health & General Preventive Medicine Physician
  • Bristol, TN
National Provider Identifier
1114348745
Registry record updated Dec 28, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health & General Preventive Medicine PhysicianTaxonomy code 2083P0901X
License
MD17978 Issued in TN
Practice address
1241 Volunteer Pkwy
Suite 950
Bristol, TN 37620-4659
Phone
(423) 968-9533
Fax
(423) 968-3567
NPI assigned
Dec 28, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health & General Preventive Medicine Physician 2083P0901X MD17978 TN Primary

Addresses

Primary practice location

1241 Volunteer Pkwy
Suite 950
Bristol, TN 37620-4659

Mailing address

1241 Volunteer Pkwy
Suite 950
Bristol, TN 37620-4659
Phone (423) 968-9533

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)
Not enrolled
Credentials
Master of Business Administration, Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD17978TNMDPublic Health & General Preventive Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1388188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1388188800000",
    "number": "1114348745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 VOLUNTEER PKWY",
            "address_2": "SUITE 950",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204659",
            "telephone_number": "423-968-9533",
            "fax_number": "423-968-3567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1241 VOLUNTEER PKWY",
            "address_2": "SUITE 950",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376204659",
            "telephone_number": "423-968-9533",
            "fax_number": "423-968-3567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHARON",
        "middle_name": "WYATT",
        "name_prefix": "Dr.",
        "credential": "MD, MBA, MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-28",
        "last_updated": "2013-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0901X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "TN",
            "license": "MD17978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.