Betty Karen Moore, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704282019 Issued in MI

Practice address

5515 Cleveland Ave
Stevensville, MI 49127-9670

Phone

(269) 429-9644

Fax

(269) 429-4002

NPI assigned

Jan 6, 2011

Last updated

Feb 25, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lakeland Medical PracticesGroup PAC ID 1658427042, 286 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Hospital, St Joseph Hospital, St Joseph, MI, CCN 230021
• Corewell Health Watervliet Hospital Hospital, Watervliet, MI, CCN 230078

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: bmoore1270941@epic00.corewelldirect.org
• Direct secure messaging: bmoore7446@lakeland.midirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lakeland Medical Practices

  dba Corewell Health Medical Group South

  • Internal Medicine Physician
  • Saint Joseph, MI
  • NPI 1538397120
  Medicare reassignment Care Compare group

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

• Lakeland Community Hospital Watervliet

  dba Corewell Health Watervliet Hospital

  • General Acute Care Hospital
  • Watervliet, MI
  • NPI 1700994845
  Care Compare affiliation
• Lakeland Hospitals at Niles and St Joseph, Inc

  dba Corewell Health Lakeland Hospitals

  • General Acute Care Hospital
  • Saint Joseph, MI
  • NPI 1134220031
  Care Compare affiliation

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1366746257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-9644",
            "fax_number": "269-429-4002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5515 CLEVELAND AVE",
            "city": "STEVENSVILLE",
            "state": "MI",
            "postal_code": "491279670",
            "telephone_number": "269-429-9644",
            "fax_number": "269-429-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BETTY",
        "middle_name": "KAREN",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-06",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704282019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366746257",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michiana Medical Supply LLC
• Alan Joseph Mileski
• Shannon Miller, LLMSW
• Mindset, LLC
• Jenilee Moody, BCBA
• James Morris, PT, DPT, CSCS
• Jonathan Moyle
• Mufarowashe Moyo, LPN
• Rhoda Msachi, PTA
• James Robert Mularczyk, DDS

• Family Nurse Practitioner in Stevensville, MI
• Providers in Stevensville, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.