Individual provider Active NPI

Christina Leigh Moore, P.A.

  • Physician Assistant
  • Bend, OR
National Provider Identifier
1457333254
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA191889 Issued in OR
Practice address
1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone
(541) 382-2811
NPI assigned
Nov 17, 2005
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA191889 OR Primary
Physician Assistant 363A00000X 103884 NC
Medical Physician Assistant 363AM0700X 103884 NC

Addresses

Primary practice location

1501 NE Medical Center Dr
Bend, OR 97701-6051

Mailing address

1501 NE Medical Center Dr
Bend, OR 97701-6051
Phone (541) 382-2811

Other practice location 1

3000 New Bern Ave
G-100
Raleigh, NC 27610-1231
Phone (919) 231-8253

Other practice location 2

2615 Hospital Rd Ste 300
Goldsboro, NC 27534-9424
Phone (919) 734-0033

Other practice location 3

2800 Blue Ridge Rd Ste 400
Raleigh, NC 27607
Phone (919) 787-5380

Other names 1

  • Ms. Christina Leigh Gunnet Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cgunnet16896@directmsg.bmctotalcare.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR
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
I20190626001247 OR Practitioner - Physician Assistant 5991699183 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bend Memorial Clinic PCGroup PAC ID 7214936533, 225 clinicians

Practice addresses (Care Compare)

1501 NE Medical Ctr Dr
Bend, OR 97701-6051
Phone (541) 382-2811

333 NW Larch Ave
Suite 2
Redmond, OR 97756-1186
Phone (541) 382-4900

815 SW Bond St
Bend, OR 97702-3593

865 SW Veterans Way
Redmond, OR 97756-2563
Phone (541) 382-2811

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA191889ORMDPhysician Assistant
103884NCMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bend Memorial Clinic PC CurrentSince Jul 1, 2019 Accepting new patients
Bend Memorial Clinic PC Physician Assistant Past Accepting new patients
Rex Hospital Inc Past Accepting new patients

Locations

1501 NE Medical Center Dr
Bend, OR 97701
Phone (541) 317-4354

Organizations & group practices 3

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 4

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": "1132185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1457333254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-2811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 NE MEDICAL CENTER DR",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016051",
            "telephone_number": "541-382-2811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3000 New Bern Ave",
            "address_2": "G-100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276101231",
            "country_code": "US",
            "telephone_number": "919-231-8253",
            "fax_number": "919-231-9546",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2615 Hospital Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Goldsboro",
            "state": "NC",
            "postal_code": "275349424",
            "country_code": "US",
            "telephone_number": "919-734-0033",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2800 Blue Ridge Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "27607",
            "country_code": "US",
            "telephone_number": "919-787-5380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTINA",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-17",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA191889",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "103884",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "103884",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cgunnet16896@directmsg.bmctotalcare.com",
            "affiliation": "N",
            "address_1": "1501 NE Medical Center Dr",
            "city": "Bend",
            "state": "OR",
            "country_code": "US",
            "postal_code": "977016051",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTINA",
            "last_name": "GUNNET",
            "middle_name": "LEIGH",
            "prefix": "MS.",
            "credential": "P.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

Verify at the official NPI Registry.