Individual provider Active NPI

Wendy L Moore, FNP-BC

  • Family Nurse Practitioner
  • Greenfield, WI
National Provider Identifier
1376896639
Registry record updated Feb 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
5102-33 Issued in WI
Practice address
4131 W Loomis Rd
Ste 300
Greenfield, WI 53221-2057
Phone
(414) 325-7246
Fax
(414) 325-3770
NPI assigned
Oct 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 5102-33 WI Primary

Addresses

Primary practice location

4131 W Loomis Rd
Ste 300
Greenfield, WI 53221-2057

Mailing address

4131 W Loomis Rd
Ste 300
Greenfield, WI 53221-2057
Phone (414) 325-7246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20160303001032 TX Practitioner - Nurse Practitioner 7012141211 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

2655 Villa Creek Dr
Dallas, TX 75234-7324
Phone (214) 645-0624

5303 Harry Hines Blvd
Dallas, TX 75390-7208

5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone (214) 645-8200

5323 Harry Hines Blvd
Dallas, TX 75390-9257

800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.87 of 100Reported as group
Quality
70.15
Promoting interoperability
100
Improvement activities
40
Cost
72.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
5102-33WIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 9, 2016 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Jan 9, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Past Accepting new patients

Locations

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

2655 Villa Creek Dr
Farmers Branch, TX 75234
Phone (214) 736-8376

5303 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-2300

Interoperability endpoints

  • Direct secure messaging: wendy.moore@direct.swmed.us

Organizations & group practices 5

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": "1350950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393286400000",
    "number": "1376896639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4131 W LOOMIS RD",
            "address_2": "STE 300",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532212057",
            "telephone_number": "414-325-7246",
            "fax_number": "414-325-3770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WENDY",
        "middle_name": "L",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-23",
        "last_updated": "2014-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "5102-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

Verify at the official NPI Registry.