Maranda J Moore, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

124571 Issued in AR

Practice address

10812 Rob Hill Rd
Dardanelle, AR 72834-8108

Phone

(479) 453-6216

NPI assigned

Aug 20, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

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

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maranda.moore.1@27812.direct.athenahealth.com

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.

• White Oak Medical Clinic

  • Primary Care Nurse Practitioner
  • Hector, AR
  • NPI 1962110031

  AR

  Medicare reassignment NPD Authorized official
• Dardanelle Regional, LLC

  • Medicare Defined Swing Bed Hospital Unit
  • Dardanelle, AR
  • NPI 1023109097

  AR

  Medicare reassignment NPD

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

{
    "created_epoch": "1597881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597881600000",
    "number": "1215549217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10812 ROB HILL RD",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728348108",
            "telephone_number": "479-453-6216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10812 ROB HILL RD",
            "city": "DARDANELLE",
            "state": "AR",
            "postal_code": "728348108",
            "telephone_number": "479-453-6216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARANDA",
        "middle_name": "J",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-08-20",
        "last_updated": "2020-08-20",
        "certification_date": "2020-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "124571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McCormick Family Dentistry
• Michael D McCormick, DDS
• William Michael McCormick, D.D.S.
• Virginia Mistler, APRN
• Dennis Molina-Aguilar, DDS
• Pam Woodson Professional Counseling, Inc.
• Kathryn I Parker, M.D.
• Russell Pearson, D.C.
• Hunter Augustus Ramey, MD, MPH
• Rehoboth, Incorporated

• Family Nurse Practitioner in Dardanelle, AR
• Providers in Dardanelle, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.