Individual provider Active NPI

Robert Allen Moore III, PA-C

  • Surgical Physician Assistant
  • Asheville, NC
National Provider Identifier
1336505080
Registry record updated May 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
0010-06136 Issued in NC
Practice address
1100 Tunnel Rd
Asheville, NC 28805-2087
Phone
(828) 298-7911
NPI assigned
Jan 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0010-06136 NC
Surgical Physician Assistant 363AS0400X 0010-06136 NC Primary

Addresses

Primary practice location

1100 Tunnel Rd
Asheville, NC 28805-2087

Mailing address

100 Victoria Rd
Asheville, NC 28801-4812

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20160301002018 NC Practitioner - Physician Assistant 6204131147 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
0010-06136NCMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mission Medical Associates, Inc CurrentSince May 1, 2018 Accepting new patients
Mission Hospital Inc CurrentSince Jan 25, 2016 Accepting new patients
Mission Hospital, Inc. CurrentSince Jan 25, 2016 Accepting new patients

Locations

1 Hospital Dr
Asheville, NC 28801
Phone (828) 213-1994

50 Schenck Pkwy
Asheville, NC 28803
Phone (828) 526-4346

1 Hospital Dr
Ste 4100
Asheville, NC 28801
Phone (828) 213-4600

100 Victoria Rd
Asheville, NC 28801
Phone (828) 213-8074

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

189 Hospital Dr
Spruce Pine, NC 28777
Phone (828) 682-0200

Organizations & group practices 3

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": "1452470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1336505080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 VICTORIA RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288014812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 TUNNEL RD",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288052087",
            "telephone_number": "828-298-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ROBERT",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-11",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-06136",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NC",
            "license": "0010-06136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

Verify at the official NPI Registry.