Active NPI
William Wyatt Moore, N.P.
- Nurse Practitioner
- Gautier, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- R867645
- Practice address
- 2105 Old Spanish TRL
Gautier, MS 39553-6000 - Phone
- (228) 497-9123
- Fax
- (228) 497-0647
- NPI assigned
- Aug 31, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | R867645 | MS | Primary |
Addresses
Primary practice location
2105 Old Spanish TRL
Gautier, MS 39553-6000
Mailing address
2105 Old Spanish TRL
Gautier, MS 39553-6000
Phone (228) 497-9123
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1340 Broad Ave
Gulfport, MS 39501-2460
1340 Broad Ave
Gulfport, MS 39501-2465
14209 Cook Rd
Biloxi, MS 39532-9719
Phone (228) 575-2536
14213 Cook Rd
BLDG a
Biloxi, MS 39532-9719
Phone (228) 575-2545
3434 Bienville Blvd
Ocean Springs, MS 39564-5732
Phone (228) 875-1599
4603 Hospital St
Pascagoula, MS 39581-5337
Phone (228) 822-6040
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R867645 | MS | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Current | Accepting new patients | |
| Memorial Hospital at Gulfport | Past | Accepting new patients |
Locations
1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856
3434 Bienville Blvd
Ocean Springs, MS 39564
Phone (228) 244-0067
Interoperability endpoints
- wwmoore@direct.mhg.com
Organizations & group practices 4
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.
-
- Urology Physician
- Gulfport, MS
- NPI 1093142598
-
- General Acute Care Hospital
- Biloxi, MS
- NPI 1215546635
-
- Emergency Medicine Physician
- Gulfport, MS
- NPI 1962780379
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
Hospital & facility affiliations 66
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Gulfport, MS
- NPI 1013142066
-
- General Acute Care Hospital
- Gulfport, MS
- NPI 1073606901
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Gulfport, MS
- NPI 1184956815
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1251676800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379030400000",
"number": "1407089907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2105 OLD SPANISH TRL",
"city": "GAUTIER",
"state": "MS",
"postal_code": "395536000",
"telephone_number": "228-497-9123",
"fax_number": "228-497-0647"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2105 OLD SPANISH TRL",
"city": "GAUTIER",
"state": "MS",
"postal_code": "395536000",
"telephone_number": "228-497-9123",
"fax_number": "228-497-0647"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "WILLIAM",
"middle_name": "WYATT",
"credential": "N.P.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-08-31",
"last_updated": "2013-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MS",
"license": "R867645",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gautier, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.