Individual provider Active NPI

Alan Rather Moore, MD

  • Neurology Physician
  • Jackson, MS
National Provider Identifier
1245330133
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
18286 Issued in MS
Practice address
971 Lakeland Dr
Suite 560 Muscle and Nerve PA
Jackson, MS 39216-4607
Phone
(601) 982-9826
Fax
(601) 982-9535
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 18286 MS Primary

Addresses

Primary practice location

971 Lakeland Dr
Suite 560 Muscle and Nerve PA
Jackson, MS 39216-4607

Mailing address

971 Lakeland Dr
Suite 560
Jackson, MS 39216-4607
Phone (601) 982-9826

Other identifiers 4

IdentifierTypeStateIssuer
09014965MedicaidMS
P00159488OtherRAILROAD MEDICARE
06772854MedicaidMS
DC2890OtherRAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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
I20040720000182 MS Practitioner - Neurology 3678552882 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
University of Mississippi School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Dominic Jackson MemorialGroup PAC ID 4385531847, 56 clinicians

Practice addresses (Care Compare)

969 Lakeland Dr
Jackson, MS 39216-4606
Phone (601) 364-6175

971 Lakeland Dr
Suite 560
Jackson, MS 39216-4607
Phone (601) 982-9826

Hospital & facility affiliations

  • St Dominic-Jackson Memorial Hospital Hospital, Jackson, MS, CCN 250048

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as individual
Quality
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Muscle and Nerve PA CurrentSince Jul 1, 2004 Accepting new patients
St. Dominic Jackson Memorial CurrentSince Feb 2, 2014 Accepting new patients
St Dominic Hospital Crna'S CurrentSince Feb 2, 2014 Accepting new patients

Locations

971 Lakeland Dr
Ste 560
Jackson, MS 39216
Phone (601) 982-9826

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1245330133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 560",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164607",
            "telephone_number": "601-982-9826",
            "fax_number": "601-982-9535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "971 LAKELAND DR",
            "address_2": "SUITE 560 MUSCLE AND NERVE PA",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392164607",
            "telephone_number": "601-982-9826",
            "fax_number": "601-982-9535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ALAN",
        "middle_name": "RATHER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MS",
            "license": "18286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09014965",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00159488",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06772854",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC2890",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

Verify at the official NPI Registry.