Active NPI
Carol Ann Moore, MD
- Emergency Medicine Physician
- Greenville, NC
National Provider Identifier
1235209107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- 34223
- Practice address
- 2100 Stantonsburg Rd
Greenville, NC 27834-2818 - Phone
- (252) 744-4757
- Fax
- (252) 744-4125
- NPI assigned
- Nov 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 34223 | NC | |
| Plastic Surgery Physician | 208200000X | 34223 | NC | |
| Emergency Medicine Physician | 207P00000X | 34223 | NC | Primary |
Addresses
Primary practice location
2100 Stantonsburg Rd
Greenville, NC 27834-2818
Mailing address
PO Box 751069
Charlotte, NC 28275-1069
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 60198 | Other | NC | BCBSNC |
| 8960198 | Medicaid | NC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251027000203 | NC | Order and Referring Only - Family Practice | 4880678903 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1632960000000",
"number": "1235209107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 751069",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282751069"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 STANTONSBURG RD",
"city": "GREENVILLE",
"state": "NC",
"postal_code": "278342818",
"telephone_number": "252-744-4757",
"fax_number": "252-744-4125"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "CAROL",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2021-09-30",
"certification_date": "2021-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NC",
"license": "34223",
"primary": false
},
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "NC",
"license": "34223",
"primary": false
},
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "NC",
"license": "34223",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSNC",
"identifier": "60198",
"state": "NC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8960198",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Greenville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2021; 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.