Individual provider Active NPI

Wanda J. McMoore, MSN, FNP-BC

  • Family Nurse Practitioner
  • Lebanon, TN
National Provider Identifier
1457823387
Registry record updated Dec 31, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN25181 Issued in TN
Practice address
100 Physicians Way Ste 300
Lebanon, TN 37090-8103
Phone
(615) 449-6868
Fax
(615) 449-7184
NPI assigned
Dec 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2019

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 APN25181 TN Primary

Addresses

Primary practice location

100 Physicians Way Ste 300
Lebanon, TN 37090-8103

Mailing address

4984 Tulip Grove LN
Hermitage, TN 37076-4417
Phone (931) 338-1287

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20190515002060 TN Practitioner - Nurse Practitioner 5294078242 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Thomas Medical PartnersGroup PAC ID 1557269354, 588 clinicians

Practice addresses (Care Compare)

4230 Harding Pike
Suite 330
Nashville, TN 37205-2018
Phone (615) 269-4545

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
APN25181TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Thomas Medical Partners CurrentSince Apr 1, 2019 Accepting new patients
Saint Thomas Medical Partners CurrentSince Apr 1, 2019 Accepting new patients

Locations

100 Physicians Way
Ste 300
Lebanon, TN 37090
Phone (615) 449-6868

4230 Harding Pike
Ste 330
Nashville, TN 37205
Phone (800) 345-5016

300 20th Ave N
Fl 9
Nashville, TN 37203

Interoperability endpoints

  • Direct secure messaging: wanda.mcmoore.1@7654.direct.athenahealth.com

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577750400000",
    "number": "1457823387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4984 TULIP GROVE LN",
            "city": "HERMITAGE",
            "state": "TN",
            "postal_code": "370764417",
            "telephone_number": "931-338-1287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 PHYSICIANS WAY STE 300",
            "city": "LEBANON",
            "state": "TN",
            "postal_code": "370908103",
            "telephone_number": "615-449-6868",
            "fax_number": "615-449-7184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMOORE",
        "first_name": "WANDA",
        "middle_name": "J.",
        "credential": "MSN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2019-12-31",
        "certification_date": "2019-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN25181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, TN

Sources for this page

Verify at the official NPI Registry.