Individual provider Active NPI

James Kyle Moore, D.O.

  • Emergency Medicine Physician
  • Nashville, TN
National Provider Identifier
1205299005
Registry record updated Jul 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
3694 Issued in TN
Practice address
5501B New York Ave
Nashville, TN 37209-1426
Phone
(615) 601-3900
Fax
(615) 412-2718
NPI assigned
Mar 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2025

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 3694 TN Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5501B New York Ave
Nashville, TN 37209-1426

Mailing address

5501B New York Ave
Nashville, TN 37209-1426
Phone (615) 601-3900

Other practice location 1

2500 N State St
Jackson, MS 39216-4500
Phone (601) 984-5582

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190731000403 TN Practitioner - Emergency Medicine 3577859883 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3694TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of TN, PC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients

Locations

111 Highway 70 E
Dickson, TN 37055
Phone (615) 441-2357

355 New Shackle Island Rd
Hendersonvlle, TN 37075
Phone (615) 264-4000

2300 Patterson St
Nashville, TN 37203
Phone (615) 342-1500

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1459296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751500800000",
    "number": "1205299005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501B NEW YORK AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091426",
            "telephone_number": "615-601-3900",
            "fax_number": "615-412-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501B NEW YORK AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372091426",
            "telephone_number": "615-601-3900",
            "fax_number": "615-412-2718"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JAMES",
        "middle_name": "KYLE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-30",
        "last_updated": "2025-07-03",
        "certification_date": "2025-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "3694",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashville, TN

Sources for this page

Verify at the official NPI Registry.