Clayton Shuford Moore, FNP-BC, NP-C
Individual provider Active NPI Family Nurse Practitioner · Forest City, NC
NPI 1225807233 · NPPES record last updated Aug 18, 2024
Key facts
- NPI
- 1225807233
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 5019362 (NC)
- Practice address
- 127 E Trade St Ste B100
Forest City, NC 28043-2201 - Phone
- (828) 220-4174
- Fax
- (833) 972-5139
- NPI assigned
- Jan 2, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Hospital & facility affiliations 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
- Group practices
- Magnolia Health, PLLC
Practice addresses (Care Compare)
127 E Trade St
Suite B100
Forest City, NC 28043-2201
Phone 8282204174101
Hospital & facility affiliations
- Rutherford Regional Medical Center
- Advent Health Polk
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240302000427 | NC | Practitioner - Nurse Practitioner | 4981049756 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5019362 | NC | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Asheville Family Health Care P.a. | Current |
Accepting new patients | |
| Magnolia Health, PLLC | Family | Current |
Accepting new patients |
| Magnolia Health, PLLC | Current |
Accepting new patients |
Locations
997 Old US Hwy 70 W
Black Mtn, NC 28711
Phone (828) 275-7981
997 Old US Hwy 70 W
Ste A
Black Mtn, NC 28711
Phone (828) 298-7981
127 E Trade St
Ste B100
Forest City, NC 28043
Phone (828) 220-4174
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 5019362 | NC | Yes |
Addresses
Primary practice location
127 E Trade St Ste B100
Forest City, NC 28043-2201
Mailing address
PO Box 335
Forest City, NC 28043-0335
Phone (828) 220-4174
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | clayton.moore.1@31258.direct.athenahealth.com |
Other providers in Forest City, NC
- Vikki Marie Mollette
- Monarch
- Monarch
- Monarch
- Ashley Rhea Monroe
- Justin Tyler Moore
- Morganton Eye Physicians, P.a.
- Morganton Eye Physicians, P.a.
- John Andrew Morris
- Samantha Lyn Morrison
All providers in Forest City, NC · Family Nurse Practitioner in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 18, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.