Individual provider Active NPI

Cheryl Moore, FNP

  • Nurse Practitioner
  • Memphis, TN
National Provider Identifier
1366486334
Registry record updated Jan 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
89816 Issued in TN
Practice address
650 New York St
Memphis, TN 38104-5536
Phone
(901) 728-5858
NPI assigned
Jun 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 89816 TN Primary

Addresses

Primary practice location

650 New York St
Memphis, TN 38104-5536

Mailing address

650 New York St
Memphis, TN 38104-5536

Other practice location 1

1700 Medical Center Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4694

Other identifiers 3

IdentifierTypeStateIssuer
78014586MedicaidKY
3641284MedicaidTN
4120637OtherTNBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20050915000680 TN Practitioner - Nurse Practitioner 2163455528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

1700 Medical Ctr Pkwy
Murfreesboro, TN 37129-2245
Phone (615) 396-4685

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
89816TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Feb 1, 2023 Accepting new patients
Medical Observation Services LLC Past Accepting new patients
Prohealth Rural Health Services, Inc Past Accepting new patients
Volunteer Medical Group, P.C. Past Accepting new patients
Prohealth Rural Health Services, Inc Past Accepting new patients
Emergency Coverage Services, PC Nurse Practitioner Past Accepting new patients

Locations

2755 New Salem Hwy
Ste 200
Murfreesboro, TN 37128
Phone (629) 218-6780

1700 Medical Center Pkwy
Murfreesboro, TN 37129
Phone (615) 396-4100

300 20th Ave N
Ste 403
Nashville, TN 37203
Phone (615) 284-4088

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675123200000",
    "number": "1366486334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 NEW YORK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 NEW YORK ST",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381045536",
            "telephone_number": "901-728-5858"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Medical Center Pkwy",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371292245",
            "country_code": "US",
            "telephone_number": "615-396-4694",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHERYL",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-01-31",
        "certification_date": "2023-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "89816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78014586",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3641284",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4120637",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.