Individual provider Active NPI

Sharon Moore, FNP

  • Family Nurse Practitioner
  • Millington, TN
National Provider Identifier
1255396859
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
8100074 Issued in MS
Practice address
8081 US Highway 51 N
Millington, TN 38053-1730
Phone
(901) 873-4194
Fax
(901) 347-1333
NPI assigned
Apr 18, 2006
Last updated
Sep 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 8100074 MS Primary
Family Nurse Practitioner 363LF0000X APN0000005418 TN

Addresses

Primary practice location

8081 US Highway 51 N
Millington, TN 38053-1730

Mailing address

8081 US Highway 51 N
Millington, TN 38053-1730
Phone (901) 873-4194

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20050629000093 TN Practitioner - Nurse Practitioner 3274578042 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
8100074MSMDFamily Nurse Practitioner
APN0000005418TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Peabody Internal Medicine, Inc. CurrentSince Sep 1, 2012 Accepting new patients

Locations

8081 US Highway 51 N
Millington, TN 38053
Phone (901) 873-4194

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1255396859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8081 US HIGHWAY 51 N",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531730",
            "telephone_number": "901-873-4194",
            "fax_number": "901-347-1333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8081 US HIGHWAY 51 N",
            "city": "MILLINGTON",
            "state": "TN",
            "postal_code": "380531730",
            "telephone_number": "901-873-4194",
            "fax_number": "901-347-1333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SHARON",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "8100074",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN0000005418",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millington, TN

Sources for this page

Verify at the official NPI Registry.