Elethia M Moore, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024189825 Issued in VA

Practice address

310 Old Ivy Way
Charlottesville, VA 22903-4896

Phone

(434) 243-6950

NPI assigned

Oct 2, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Nurse Practitioner

State licenses

Practice roles

Locations

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.

• MCV Associated Physicians

  • Anesthesiology Physician
  • Richmond, VA
  • NPI 1710959457
  Medicare reassignment NPD
• Richmond Behavioral Health Authority

  • Community/Behavioral Health Agency
  • Richmond, VA
  • NPI 1184715328
  Medicare reassignment NPD
• University of Virginia Physicians Group

  • Sports Medicine (Neuromusculoskeletal Medicine) Physician
  • Charlottesville, VA
  • NPI 1033138250
  NPD
• Rector & Visitors of the University of Virginia

  • Community/Retail Pharmacy
  • Charlottesville, VA
  • NPI 1790399202
  NPD (past)

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

{
    "created_epoch": "1538438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1114402427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 749112",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303749112",
            "telephone_number": "434-295-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 OLD IVY WAY",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229034896",
            "telephone_number": "434-243-6950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Lee St",
            "address_purpose": "LOCATION",
            "city": "Charlottesville",
            "state": "VA",
            "postal_code": "229080816",
            "country_code": "US",
            "telephone_number": "434-924-2231",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6801 Lucy Corr Ct",
            "address_purpose": "LOCATION",
            "city": "Chesterfield",
            "state": "VA",
            "postal_code": "238326657",
            "country_code": "US",
            "telephone_number": "804-768-7318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELETHIA",
        "middle_name": "M",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-02",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024189825",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336293000",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Mooney, DDS
• Amanda Moore
• Christopher Moore, M.D.
• Christopher M. Moore, M.D.
• Denee J Moore, M.D.
• Jessica Moore, DDS
• Karen Barbara Moore, MHS. PT
• Madyson Taylor Moore
• Marina Moore
• Marta J Moore, AC -PNP

• Psychiatric/Mental Health Nurse Practitioner in Charlottesville, VA
• Providers in Charlottesville, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.