Patricia Moore, NP

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

0024174222 Issued in VA

Practice address

1101 Sam Perry Blvd Ste 307
Fredericksburg, VA 22401-4466

Phone

(540) 374-3277

Fax

(540) 374-3280

NPI assigned

Oct 9, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: pmoore27180@marywashingtonhealthcare.direct-ci.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.

• Mary Washington Healthcare Physicians

  • Family Medicine Physician
  • Fredericksburg, VA
  • NPI 1295999852
  Medicare reassignment NPD
• Mary Washington Healthcare Physicians

  • Durable Medical Equipment & Medical Supplies
  • Fredericksburg, VA
  • NPI 1740853035
  NPD

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

{
    "created_epoch": "1475971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1336699800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ACACIA CT",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224052131",
            "telephone_number": "540-226-9935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 SAM PERRY BLVD STE 307",
            "city": "FREDERICKSBURG",
            "state": "VA",
            "postal_code": "224014466",
            "telephone_number": "540-374-3277",
            "fax_number": "540-374-3280"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 Telestar Ct",
            "address_purpose": "LOCATION",
            "city": "Falls Church",
            "state": "VA",
            "postal_code": "220421206",
            "country_code": "US",
            "telephone_number": "703-538-2065",
            "fax_number": "703-852-7389",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PATRICIA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WH1000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Hospice",
            "state": "VA",
            "license": "0001137010",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "VA",
            "license": "0024174222",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "VA",
            "license": "0024174222",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1336699800",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Moore
• Jason Moore, EMT-B
• Jennifer L Moore, LCSW
• Meredith Moore
• Nancy Maria Moore
• Stacy Moore
• Moore'S Care Services
• Masoud Moradi, DPM
• Nicole Morelli
• Doris Morgan, LCSW

• Gerontology Nurse Practitioner in Fredericksburg, VA
• Providers in Fredericksburg, VA by specialty
• Gerontology Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.