Elizabeth Outlaw Muchmore, PA-C, MMS, MS, RD

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9115135 Issued in FL

Practice address

204 Southpark Cir E
St Augustine, FL 32086-5135

Phone

(904) 829-8300

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Miss Elizabeth Paige Outlaw Former name

Medicare fee-for-service enrollment

Enrolled in FL

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

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Amir a Malik MD PAGroup PAC ID 4981621729, 4 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Flagler Hospital Hospital, Saint Augustine, FL, CCN 100090
• AdventHealth Palm Coast Hospital, Palm Coast, FL, CCN 100118

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

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.

• Amir a Malik MD PA

  • Nephrology Physician
  • St Augustine, FL
  • NPI 1992800106
  Medicare reassignment Care Compare group NPD
• Amir a Malik MD PA

  • Nephrology Physician
  • Palm Coast, FL
  • NPI 1922260470
  NPD

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

• Flagler Hospital Inc

  • General Acute Care Hospital
  • St Augustine, FL
  • NPI 1144211020
  Care Compare affiliation
• Flagler Hospital, Inc.

  • Urgent Care Clinic/Center
  • Saint Augustine, FL
  • NPI 1447527965

  Hospital

  Care Compare affiliation
• Memorial Hospital Flagler Inc

  • General Acute Care Hospital
  • Palm Coast, FL
  • NPI 1679678486
  Care Compare affiliation

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1306228952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HEALTH PARK BLVD",
            "address_2": "FLAGLER HOSPITAL",
            "city": "ST. AUGUSTINE",
            "state": "FL",
            "postal_code": "32086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 SOUTHPARK CIR E",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320865135",
            "telephone_number": "904-829-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUCHMORE",
        "first_name": "ELIZABETH",
        "middle_name": "OUTLAW",
        "name_prefix": "Mrs.",
        "credential": "PA-C, MMS, MS, RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9115135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "OUTLAW",
            "middle_name": "PAIGE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Moultrie Pharmacy Inc
• Movement Driven Performance Physiotherapy
• Movement, Milestones, and Mobility, PLLC
• Christina Marie Moyer, DC
• Nikki Catherine Moynihan
• Carolyn Mudgette, MASSAGE THERAPIST
• Derek D Muehrcke, MD
• Gabrielle Mueller
• Kurt Muellner, AUD
• Emma Muhaimeen

• Physician Assistant in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2024; 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.