Individual provider Active NPI

Pamela Sue Moore, FNP

  • Registered Nurse
  • Saint Clairsville, OH
National Provider Identifier
1497033286
Registry record updated Dec 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
329292 Issued in OH
Practice address
103 Plaza Dr
Suite a
Saint Clairsville, OH 43950-7729
Phone
(740) 695-9321
NPI assigned
Jul 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 329292 OH Primary
Registered Nurse 163W00000X 55726 WV
Family Nurse Practitioner 363LF0000X 2011013830 WV

Addresses

Primary practice location

103 Plaza Dr
Suite a
Saint Clairsville, OH 43950-7729

Mailing address

103 Plaza Dr
Suite a
Saint Clairsville, OH 43950-7729
Phone (740) 695-9321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
329292OHMDRegistered Nurse
55726WVMDRegistered Nurse
2011013830WVMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1311724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324598400000",
    "number": "1497033286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 PLAZA DR",
            "address_2": "SUITE A",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507729",
            "telephone_number": "740-695-9321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 PLAZA DR",
            "address_2": "SUITE A",
            "city": "SAINT CLAIRSVILLE",
            "state": "OH",
            "postal_code": "439507729",
            "telephone_number": "740-695-9321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PAMELA",
        "middle_name": "SUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-27",
        "last_updated": "2011-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "329292",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "55726",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "2011013830",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clairsville, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.