Individual provider Active NPI

Joel Richard Moore, MD

  • Emergency Medicine Physician
  • Mount Pleasant, SC
National Provider Identifier
1528200128
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
48177 Issued in TN
Practice address
East Cooper Medical Center 2000 Hospital Drive
Mount Pleasant, SC 29464
Phone
(843) 416-6100
Fax
(585) 473-3516
NPI assigned
Mar 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 48177 TN Primary

Addresses

Primary practice location

East Cooper Medical Center 2000 Hospital Drive
Mount Pleasant, SC 29464

Mailing address

East Cooper Medical Center 2000 Hospital Drive
Mount Pleasant, SC 29464
Phone (843) 416-6100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, SC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120706000164 TN Practitioner - Emergency Medicine 7214192749 Reassigns benefits to 1 organization
I20160318001125 SC Practitioner - Emergency Medicine 7214192749 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
State University of New York at Buffalo School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mount Pleasant Emergency Physicians, LLCGroup PAC ID 9537343033, 13 clinicians

Practice addresses (Care Compare)

2000 Hospital Dr
Mount Pleasant, SC 29464-3764
Phone (843) 881-0100

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
48177TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Acs Primary Care Physicians - Southeast PC Emergency Medicine CurrentSince Nov 1, 2017 Accepting new patients
Tri-Cities Regional Emergency Physicians, PC Emergency Medicine CurrentSince Apr 1, 2017 Accepting new patients

Locations

2000 Hospital Dr
Mt Pleasant, SC 29464
Phone (803) 533-2200

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 291-7182

1501 W Elk Ave
Elizabethton, TN 37643
Phone (423) 542-1300

300 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-1000

400 N State of Franklin Rd
Johnson City, TN 37604
Phone (423) 431-1310

Organizations & group practices 4

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 1

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": "1238112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1528200128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "EAST COOPER MEDICAL CENTER 2000 HOSPITAL DRIVE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-416-6100",
            "fax_number": "585-473-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST COOPER MEDICAL CENTER 2000 HOSPITAL DRIVE",
            "city": "MOUNT PLEASANT",
            "state": "SC",
            "postal_code": "29464",
            "telephone_number": "843-416-6100",
            "fax_number": "585-473-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "JOEL",
        "middle_name": "RICHARD",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-27",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TN",
            "license": "48177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Pleasant, SC

Sources for this page

Verify at the official NPI Registry.