Elizabeth Jordan Moore, MD
Individual provider Active NPI Family Medicine Physician · Branson, MO
NPI 1366071540 · NPPES record last updated Jul 27, 2023
Key facts
- NPI
- 1366071540
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 2021029939 (MO)
- Practice address
- 525 Branson Landing Blvd Ste 508
Branson, MO 65616-2131 - Phone
- (417) 335-7540
- Fax
- (417) 335-7544
- NPI assigned
- Apr 8, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Skaggs Community Hospital Association
Practice addresses (Care Compare)
525 Branson Landing Blvd
Suite 508
Branson, MO 65616-2131
Phone (417) 335-7540
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211103001022 | MO | Practitioner - Family Practice | 5496143992 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2021029939 | MO | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skaggs Community Hospital Association | Family Medicine | Current |
Accepting new patients |
| Skaggs Community Hospital Association | Family Medicine | Current |
Accepting new patients |
| Skaggs Community Hospital Association | Current | Accepting new patients | |
| Skaggs Community Hospital Association | Past | Accepting new patients | |
| Skaggs Community Hospital Association | Past | Accepting new patients |
Locations
525 Branson Landing Blvd
Ste 508
Branson, MO 65616
Phone (417) 335-7540
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 2021029939 | MO | Yes |
Addresses
Primary practice location
525 Branson Landing Blvd Ste 508
Branson, MO 65616-2131
Mailing address
PO Box 802843
Kansas City, MO 64180-2843
Phone (417) 730-6430
Other providers in Branson, MO
- Missouri CVS Pharmacy LLC
- Missouri Eye Institute of Branson LLC
- Mittie M Dragosljvich MD LLC
- Candace Mize
- Lindy Dianne Moncado
- Patricia Hogan Mort
- Linda Sue Morton
- Michael Herbert Morton
- Habib G Munshi
- Linda Muralles
All providers in Branson, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 27, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.