Elizabeth Moore, CNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

4704289705 Issued in MI

Practice address

1900 Wealthy St SE Ste 250
Grand Rapids, MI 49506-2998

Phone

(616) 774-8501

NPI assigned

Sep 20, 2016

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, CO2 enrollments

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 2

Specialty

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spectrum Health Primary Care PartnersGroup PAC ID 4587568647, 2,283 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Spectrum Health Hospital, Grand Rapids, MI, CCN 230038

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jlowe1270616@epic00.corewelldirect.org
• Direct secure messaging: emoore2371686@epic00.corewelldirect.org

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.

• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment Care Compare group NPD
• St Mary Mercy Hospital Professional

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1528145554
  Medicare reassignment NPD
• Acute Care Surgery Medical Group, Inc.

  • Surgery Physician
  • Sacramento, CA
  • NPI 1700069549

  CO

  Medicare reassignment NPD
• Healogics Specialty Physicians of Colorado-Professional, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Parker, CO
  • NPI 1114331006
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  dba Corewell Health Medical Group West

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• St Mary Mercy Hospital Crna

  • Certified Registered Nurse Anesthetist
  • Livonia, MI
  • NPI 1063602092
  NPD
• St Mary Mercy Hospital Professional

  • Gastroenterology Physician
  • Ypsilanti, MI
  • NPI 1447953971
  NPD
• Goodness Health, LLC

  dba Goodness Health - Utah

  • Internal Medicine Physician
  • Centerville, UT
  • NPI 1407659998
  NPD
• Goodness Health, LLC

  • Multi-Specialty Clinic/Center
  • Denver, CO
  • NPI 1609241264
  NPD
• Healogics Specialty Physicians of Colorado-Professional, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Lakewood, CO
  • NPI 1114559572
  NPD

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

• Pennock Hospital

  dba Corewell Health Pennock Hospital

  • Critical Access Hospital
  • Hastings, MI
  • NPI 1932695525
  Care Compare affiliation
• Spectrum Health Hospitals

  dba Corewell Health Grand Rapids Hospital

  • General Acute Care Hospital
  • Grand Rapids, MI
  • NPI 1922090554
  Care Compare affiliation

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

{
    "created_epoch": "1474329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1114475019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE # MC845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 WEALTHY ST SE STE 250",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495062998",
            "telephone_number": "616-774-8501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-09-20",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "MI",
            "license": "4704289705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jlowe1270616@epic00.corewelldirect.org",
            "affiliation": "N",
            "address_1": "1900 Wealthy St SE Ste 250",
            "city": "Grand Rapids",
            "state": "MI",
            "country_code": "US",
            "postal_code": "495062998",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Casey N Moore, BCBA
• Courtney Moore, CTRS
• Craig R Moore, MD
• David Brian Moore, LMSW
• Destiney M Moore
• Emma Moore
• Eric Moore, RPH
• Erin Nichole Moore
• Janine M Moore, PT,MS,OCS,CERT MDT
• Jeffrey Jay Moore, MA, LLPC

• Acute Care Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Acute Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.