Emily Jean Moore

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

1058466 Issued in TX

Practice address

825 E Rundberg LN
Austin, TX 78753-4808

Phone

(512) 472-4357

Fax

(512) 703-1394

NPI assigned

Nov 30, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Austin Travis County Mental Health and Mental Retardation CenterGroup PAC ID 9133016306, 64 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Austin Travis County Mental Health and Mental Retardation Center

  • Psychiatry Physician
  • Austin, TX
  • NPI 1750337259

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Austin Travis County Mental Health and Mental Retardation Center

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Austin, TX
  • NPI 1053632505
  NPD

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638230400000",
    "number": "1538827209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 COLLIER ST",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787042911",
            "telephone_number": "512-472-4357",
            "fax_number": "512-703-1394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 E RUNDBERG LN",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787534808",
            "telephone_number": "512-472-4357",
            "fax_number": "512-703-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "EMILY",
        "middle_name": "JEAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1058466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher D Moore, LPC
• Dakota Moore, RBT
• Darrius Moore
• Deante Davon Moore
• Elzbieta Zuzanna Moore, PH.D., MS, CMSHN
• Erin Moore
• Eva Marie Moore, PHARMACIST INTERN
• Farah Moore, MA, OTR/L
• Francesca Alexandra Moore, LAC, LMT
• Hayley Renae Moore

• Psychiatric/Mental Health Nurse Practitioner in Austin, TX
• Providers in Austin, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.