NPIMap

Individual provider Active NPI

Brad Edward Moore, NP

  • Family Nurse Practitioner
  • Johnson City, TN
National Provider Identifier
1578094207
Registry record updated May 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
22515 Issued in TN
Practice address
301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641
Phone
(423) 794-5520
Fax
(423) 282-6940
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 194218 TN
Family Nurse Practitioner 363LF0000X 22515 TN Primary

Addresses

Primary practice location

301 Med Tech Pkwy Ste 240
Johnson City, TN 37604-2641

Mailing address

PO Box 632476
Cincinnati, OH 45263-2476
Phone (423) 794-5520

Other names 1

  • Brad E Moore Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170425001538 TN Practitioner - Nurse Practitioner 6800173097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tusculum Physician Services PCGroup PAC ID 7719476415, 35 clinicians
State of Franklin Healthcare Associates, PLLCGroup PAC ID 2466346291, 258 clinicians

Practice addresses (Care Compare)

1420 Tusculum Blvd
Greeneville, TN 37745-4279
Phone (423) 787-5000

301 Med Tech Pkwy
Johnson City, TN 37604-2364
Phone (423) 794-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
194218TNMDRegistered Nurse
22515TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Health System Current Accepting new patients
Blue Ridge Medical Management Corporation CurrentSince Sep 30, 2022 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince May 29, 2022 Accepting new patients
State of Franklin Healthcare Associates PLLC CurrentSince Apr 1, 2022 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Blue Ridge Medical Management C Orporation CurrentSince Sep 30, 2022 Accepting new patients

Locations

1497 W Elk Ave
Ste 20
Elizabethton, TN 37643
Phone (423) 547-7380

1744 E Andrew Johnson Hwy
Greeneville, TN 37745
Phone (423) 636-8891

301 Med Tech Pkwy
Ste 240
Johnson City, TN 37604
Phone (423) 794-5520

1019 W Oakland Ave
Ste 1
Johnson City, TN 37604
Phone (423) 915-5000

313 Princeton Rd
Ste 3
Johnson City, TN 37601
Phone (423) 282-4819

301 Med Tech Pkwy
Johnson City, TN 37604
Phone (423) 302-6239

851 Locust St
Rogersville, TN 37857
Phone (423) 272-2671

Interoperability endpoints

  • Direct secure messaging: bmoore22340@balladhealth.medalliesdirect.net
  • FHIR API: https://api.platform.athenahealth.com/24871/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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 6

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779235200000",
    "number": "1578094207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632476",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632476",
            "telephone_number": "423-794-5520",
            "fax_number": "234-283-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 MED TECH PKWY STE 240",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042641",
            "telephone_number": "423-794-5520",
            "fax_number": "423-282-6940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRAD",
        "middle_name": "EDWARD",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2026-05-20",
        "certification_date": "2026-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "194218",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "22515",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRAD",
            "last_name": "MOORE",
            "middle_name": "E",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.