Individual provider Active NPI

Margaret L. Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Homewood, AL
National Provider Identifier
1326088766
Registry record updated Aug 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
1-052404 Issued in AL
Practice address
2621 19TH St S
Homewood, AL 35209
Phone
(205) 271-8200
Fax
(205) 271-8217
NPI assigned
Jun 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 1-052404 AL Primary

Addresses

Primary practice location

2621 19TH St S
Homewood, AL 35209

Mailing address

2151 Old Rocky Ridge Rd
Suite 106
Birmingham, AL 35216-6101
Phone (205) 989-1080

Other identifiers 3

IdentifierTypeStateIssuer
515-32935OtherALBLUECROSS BLUESHIELD AL
P00297305OtherALMED-RAILROAD
051557298MedicaidAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060228000477 AL Practitioner - Certified Registered Nurse Anesthetist (Crna) 0244246205 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-052404ALMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Ambulatory Anesthesia & Pain Medicine, P.C. CurrentSince Sep 10, 2006 Accepting new patients
Anesthesia Services of Birmingham, P.C. Past Accepting new patients

Locations

2621 19th St S
Homewood, AL 35209
Phone (205) 271-8019

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533081600000",
    "number": "1326088766",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2151 OLD ROCKY RIDGE RD",
            "address_2": "SUITE 106",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352166101",
            "telephone_number": "205-989-1080",
            "fax_number": "205-989-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 19TH ST S",
            "city": "HOMEWOOD",
            "state": "AL",
            "postal_code": "35209",
            "telephone_number": "205-271-8200",
            "fax_number": "205-271-8217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARGARET",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "AL",
            "license": "1-052404",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD AL",
            "identifier": "515-32935",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MED-RAILROAD",
            "identifier": "P00297305",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "051557298",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homewood, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.