Stacy Cathryn Moore, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

0024169559 Issued in VA

Practice address

118 Broad St
Dublin, VA 24084-3211

Phone

(540) 674-8804

Fax

(540) 678-8670

NPI assigned

Aug 18, 2011

Last updated

Dec 7, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

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, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Carilion Healthcare CorporationGroup PAC ID 5890607253, 540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Carilion New River Valley Medical Center Hospital, Christiansburg, VA, CCN 490042
• Carilion Medical Center Hospital, Roanoke, VA, CCN 490024

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smoore32656@direct.carilionclinic.org

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.

• Carilion Healthcare Corporation

  dba Bridgewater College Student Health Center

  • Multi-Specialty Clinic/Center
  • Roanoke, VA
  • NPI 1447206370
  Medicare reassignment Care Compare group NPD
• Carilion Healthcare Corporation

  • Durable Medical Equipment & Medical Supplies
  • Blacksburg, VA
  • NPI 1407667256
  NPD

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

• Carilion Medical Center

  dba Carilion Roanoke Memorial Hospital

  • General Acute Care Hospital
  • Roanoke, VA
  • NPI 1033102942
  Care Compare affiliation
• Carilion New River Valley Medical Center

  • General Acute Care Hospital
  • Christiansburg, VA
  • NPI 1376536573
  Care Compare affiliation

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

{
    "created_epoch": "1313625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1407136773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 BROAD ST",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240843211",
            "telephone_number": "540-674-8805",
            "fax_number": "540-674-8670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 BROAD ST",
            "city": "DUBLIN",
            "state": "VA",
            "postal_code": "240843211",
            "telephone_number": "540-674-8804",
            "fax_number": "540-678-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "STACY",
        "middle_name": "CATHRYN",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-08-18",
        "last_updated": "2020-12-07",
        "certification_date": "2020-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "0024169559",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoore32656@direct.carilionclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "smoore32656@direct.carilionclinic.org",
            "address_1": "118 Broad St",
            "city": "Dublin",
            "state": "VA",
            "country_code": "US",
            "postal_code": "240843211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Leann Carol Meredith, FNP-C
• MH Health Care Services, PC
• Amy Givens Moler, LPC
• Miranda Katelynn Montgomery, OTD, OTR/L
• Michael Bryan Moore, PHD
• Jackie L Morgan, PA C
• New River Medical Associates, Inc
• Orthopedic Services PLLC
• Amanda Kay Page, P.A.
• Pain Management Centers of Southwest Virginia

• Family Nurse Practitioner in Dublin, VA
• Providers in Dublin, VA by specialty
• Family Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.