Lisa Tingen Moore, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

5016303 Issued in NC

Practice address

1695 Kernersville Medical Parkway
Kernersville, NC 27284

Phone

(336) 515-5000

NPI assigned

Jun 3, 2022

Sex

Female

Sole proprietor

No

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 NC

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

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.

• Salisbury Vamc

  • Department of Veterans Affairs (VA) Pharmacy
  • Kernersville, NC
  • NPI 1982652723
  NPD

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654214400000",
    "number": "1255070439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4670 MERRIWEATHER RD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271076430",
            "telephone_number": "336-785-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1695 KERNERSVILLE MEDICAL PARKWAY",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "27284",
            "telephone_number": "336-515-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LISA",
        "middle_name": "TINGEN",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-03",
        "certification_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5016303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Monde
• Monolias Care and Consulting Services LLC
• Shawanna Nicole Moore-Geter, LCMHC
• Amber Moore, LCAS, SAP
• Jeremy Moore
• Lynn Chorey Moore Sr., PHARMD
• Mary Patricia Moore, M.D.
• Megan Moore
• Octavia Moore
• Slade Curtis Moore, M.D.

• Adult Health Nurse Practitioner in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Adult Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2022; 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.