Molly Anne Moore-Pullin, A.N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN049339 Issued in AZ

Practice address

802 Ainsworth Dr Ste a
Prescott, AZ 86301-1623

Phone

(928) 445-6025

Fax

(928) 777-2423

NPI assigned

Oct 14, 2005

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

Other names 1

• Molly A Moore Former name

Medicare fee-for-service enrollment

Enrolled in TN

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

Nurse Practitioner

Practice roles

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.

• Advanced Cardiac Specialists, Chartered

  • Ambulatory Surgical Clinic/Center
  • Mesa, AZ
  • NPI 1912174590
  NPD (past)

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1154310902",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5874",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 AINSWORTH DR STE A",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863011623",
            "telephone_number": "928-445-6025",
            "fax_number": "928-777-2423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE-PULLIN",
        "first_name": "MOLLY",
        "middle_name": "ANNE",
        "credential": "A.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "AZ",
            "license": "RN049339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL PTAN",
            "identifier": "Z214401",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "MOORE",
            "middle_name": "A",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kathryn Quinn Montoya, LMT
• Monty Shultz Counseling & Neurofeedback LLC
• Monty Shultz Counseling LLC
• Lisa Ann Monville
• Deborah Moon, PT
• Audrey Elaine Moore, LAC
• Bertha Jean Moore, RN
• Jennifer Anne Moore, FNP-BC
• Kristin Moore
• Laura Jeanne Moore, LPC

• All providers in Prescott, AZ
• Adult Health Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.