Individual provider Active NPI

Carly Moore, MSN, APRN, FNP-C

  • Family Nurse Practitioner
  • Missoula, MT
National Provider Identifier
1457081846
Registry record updated Apr 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
NUR-APRN-LIC-195589 Issued in MT
Practice address
2831 Fort Missoula Rd Ste 146
Missoula, MT 59804-7401
Phone
(406) 327-3850
Fax
(406) 327-3851
NPI assigned
Jun 16, 2022
Last updated
Apr 1, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2024

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 NUR-APRN-LIC-195589 MT Primary

Addresses

Primary practice location

2831 Fort Missoula Rd Ste 146
Missoula, MT 59804-7401

Mailing address

2831 Fort Missoula Rd Ste 146
Missoula, MT 59804-7401
Phone (406) 327-3850

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address crmoore@communitymed.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20230119000073 MT Practitioner - Nurse Practitioner 4981075512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RCHP Billings - Missoula LLCGroup PAC ID 8426370842, 69 clinicians

Practice addresses (Care Compare)

2831 Fort Missoula Rd
Suite 146
Missoula, MT 59804-7401
Phone (406) 327-3880

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
NUR-APRN-LIC-195589MTMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
RCHP Billings - Missoula LLC Family CurrentSince Jan 1, 2023 Accepting new patients
RCHP Billings - Missoula LLC CurrentSince Jan 1, 2023 Accepting new patients

Locations

2230 N Reserve St
Missoula, MT 59808
Phone (406) 721-0533

2230 N Reserve St
Ste 402
Missoula, MT 59808
Phone (406) 327-3850

2825 Fort Missoula Rd
Ste 217
Missoula, MT 59804
Phone (406) 327-3850

2827 Fort Missoula Rd
Missoula, MT 59804
Phone (406) 327-4202

2827 Fort Missoula Rd
Ste 146
Missoula, MT 59804

2831 Fort Missoula Rd
Ste 146
Missoula, MT 59804
Phone (406) 327-3850

Interoperability endpoints

  • Direct secure messaging: crmoore@direct.communitymed.org

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1655337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711929600000",
    "number": "1457081846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD STE 146",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047401",
            "telephone_number": "406-327-3850",
            "fax_number": "406-327-3851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2831 FORT MISSOULA RD STE 146",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598047401",
            "telephone_number": "406-327-3850",
            "fax_number": "406-327-3851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CARLY",
        "credential": "MSN, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-16",
        "last_updated": "2024-04-01",
        "certification_date": "2024-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MT",
            "license": "NUR-APRN-LIC-195589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "crmoore@communitymed.org",
            "affiliation": "N",
            "endpointDescription": "Work email",
            "address_1": "2831 Fort Missoula Rd Ste 146",
            "city": "Missoula",
            "state": "MT",
            "country_code": "US",
            "postal_code": "598047401",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.