Stacy Lynn Moore, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-092232 Issued in AL

Practice address

156 Titan Dr
Florence, AL 35630-1197

Phone

(256) 740-0690

Fax

(256) 740-0694

NPI assigned

Jan 6, 2020

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 AL

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Florence OB/GYN Group, PCGroup PAC ID 3577580075, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoore@flwp-al.direct.office.nextgen.com

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.

• Full Life Wellness, PC

  • Multi-Specialty Clinic/Center
  • Florence, AL
  • NPI 1750495156
  Medicare reassignment Care Compare group NPD
• Joseph a Lukaska, MD Family Medicine, PLLC

  • Family Medicine Physician
  • Lawrenceburg, TN
  • NPI 1669623880
  NPD (past)

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

{
    "created_epoch": "1578268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1265071450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 TITAN DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301197",
            "telephone_number": "256-740-0690",
            "fax_number": "256-740-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 TITAN DR",
            "city": "FLORENCE",
            "state": "AL",
            "postal_code": "356301197",
            "telephone_number": "256-740-0690",
            "fax_number": "256-740-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STACY",
        "middle_name": "LYNN",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-06",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-092232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candace J Moore
• Charles Edward Moore Jr., M.D.
• Judy Thompson Moore, M.D.
• Marsha Lynn Moore
• Rebekah Butler Moore, CRNP
• Taylor Norton Moore, OTR/L
• Thomas Lowell Moore, PH.D.
• Warren Hampton Moore, OD
• Daniel Lee Morris Jr., D.M.D, M.D.
• Felix Arthur Morris, M.D.

• Family Nurse Practitioner in Florence, AL
• Providers in Florence, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.