Laura Loomer Moylan, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

0101044609 Issued in VA

Practice address

1930 Braeburn Dr
Suite B
Salem, VA 24153-7391

Phone

(540) 776-6800

Fax

(540) 776-2919

NPI assigned

Apr 9, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Dec 3, 2012 through Dec 3, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1144540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287705600000",
    "number": "1235192527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6008 CAVALIER DR",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240183880",
            "telephone_number": "540-772-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 BRAEBURN DR",
            "address_2": "SUITE B",
            "city": "SALEM",
            "state": "VA",
            "postal_code": "241537391",
            "telephone_number": "540-776-6800",
            "fax_number": "540-776-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYLAN",
        "first_name": "LAURA",
        "middle_name": "LOOMER",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-04-09",
        "last_updated": "2010-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "0101044609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "54-1832336",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6209718",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "282028",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jason Mark Morris, DO
• Tamara Derrise Morton, M.S., R.D.
• Mahdieh Moslemi
• Mount Baker Emergency Physicians LLC
• Laurie E Moyer, PA-C
• Robert D Moylan, MD
• Rami Nael Muhtaseb, MD
• Margaret Skelly Mulcahy, LCSW
• Christopher Anthony Muller, PH.D.
• Patricia Mikes Muller, ANP

• Specialist in Salem, VA
• Providers in Salem, VA by specialty
• Specialist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2010; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.