Individual provider Active NPI

Elisabeth Moore, MD

  • Emergency Medicine Physician
  • Berlin, NH
National Provider Identifier
1205060167
Registry record updated Apr 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
18810 Issued in NH
Practice address
59 Page Hill Rd
Berlin, NH 03570-3531
Phone
(603) 752-2200
Fax
(603) 752-1836
NPI assigned
May 7, 2009
Last updated
Apr 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2019

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 042-0012485 VT
Emergency Medicine Physician 207P00000X 18810 NH Primary

Addresses

Primary practice location

59 Page Hill Rd
Berlin, NH 03570-3531

Mailing address

189 Prouty Dr
Newport, VT 05855-9326
Phone (802) 334-7900

Other practice location 1

189 Prouty Dr
Newport, VT 05855-9326
Phone (802) 334-7900

Other names 1

  • Elisabeth Pierson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT, NH2 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
I20120924000389 VT Practitioner - Emergency Medicine 0345498978
I20180622000410 NH Practitioner - Emergency Medicine 0345498978 Reassigns benefits to 7 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18810NHMDEmergency Medicine Physician
042-0012485VTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Weeks Medical Center CurrentSince Apr 3, 2019 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Aug 30, 2018 Accepting new patients
Androscoggin Valley Hospital, Inc. CurrentSince Aug 30, 2018 Accepting new patients
Weeks Medical Center Current Accepting new patients
Weeks Medical Center CurrentSince Apr 3, 2019 Accepting new patients
Androscoggin Valley Hospital Inc CurrentSince Aug 30, 2018 Accepting new patients
Upper Connecticut Valley Hospital Association CurrentSince Jan 31, 2019 Accepting new patients

Locations

59 Page Hill Rd
Berlin, NH 03570
Phone (603) 752-2200

7 Page Hill Rd
Berlin, NH 03570
Phone (603) 326-5827

181 Corliss Ln
Colebrook, NH 03576
Phone (603) 237-8652

173 Middle St
Lancaster, NH 03584
Phone (603) 788-4911

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1241654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554854400000",
    "number": "1205060167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 PROUTY DR",
            "city": "NEWPORT",
            "state": "VT",
            "postal_code": "058559326",
            "telephone_number": "802-334-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 PAGE HILL RD",
            "city": "BERLIN",
            "state": "NH",
            "postal_code": "035703531",
            "telephone_number": "603-752-2200",
            "fax_number": "603-752-1836"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "189 Prouty Dr",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "VT",
            "postal_code": "058559326",
            "country_code": "US",
            "telephone_number": "802-334-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELISABETH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-07",
        "last_updated": "2019-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "VT",
            "license": "042-0012485",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "18810",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELISABETH",
            "last_name": "PIERSON",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Berlin, NH

Sources for this page

Verify at the official NPI Registry.