Individual provider Active NPI

Angela Danielle Moore

  • Family Nurse Practitioner
  • Cookeville, TN
National Provider Identifier
1609137587
Registry record updated Feb 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
16830 Issued in TN
Practice address
851 S Willow Ave Ste 112
Cookeville, TN 38501-4222
Phone
(615) 941-8501
Fax
(615) 941-8102
NPI assigned
Jun 6, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 16830 TN
Family Nurse Practitioner 363LF0000X 16830 TN Primary

Addresses

Primary practice location

851 S Willow Ave Ste 112
Cookeville, TN 38501-4222

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 239-2018

Other practice location 1

776 Weatherly Dr Ste B
Clarksville, TN 37043-8922
Phone (615) 941-8501

Other practice location 2

5801 Crossings Blvd
Antioch, TN 37013-3130
Phone (615) 941-8501

Other practice location 3

1547 Warrior Dr Ste A
Murfreesboro, TN 37128-0922
Phone (615) 941-8501

Other practice location 4

1642 Westgate Cir Ste 201
Brentwood, TN 37027-8587
Phone (615) 941-8501

Other practice location 5

2222 State St Ste C
Nashville, TN 37203-1869
Phone (615) 941-8501

Other practice location 6

300 20th Ave N Ste 600
Nashville, TN 37203-2143
Phone (615) 941-8501

Other practice location 7

320 New Shackle Island Rd
Hendersonville, TN 37075-2312
Phone (615) 941-8501

Other practice location 8

405 Steam Plant Rd Ste 200
Gallatin, TN 37066-3375
Phone (615) 941-8501

Other practice location 9

40 W Caldwell St Ste 200
MT Juliet, TN 37122-3179
Phone (615) 941-8501

Other names 1

  • Angela Danielle Lambeth Former name

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
I20120720000435 TN Practitioner - Nurse Practitioner 3173789062 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coffee County Hospital Group IncGroup PAC ID 1456317783, 87 clinicians

Practice addresses (Care Compare)

482 Interstate Dr
Suite a
Manchester, TN 37355-3109
Phone (931) 728-4718

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
16830TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Diagnostic Imaging, PC Nurse Practitioner CurrentSince Nov 8, 2021 Accepting new patients
Advanced Diagnostic Imaging PC CurrentSince Nov 8, 2021 Accepting new patients
Regional Rehabilitation Center, PLLC PastSince Jul 24, 2017 Accepting new patients
Coffee Medical Group LLC Past Accepting new patients

Locations

5801 Crossings Blvd
Antioch, TN 37013
Phone (615) 885-0909

1642 Westgate Cir
Ste 201
Brentwood, TN 37027

776 Weatherly Dr
Ste B
Clarksville, TN 37043
Phone (615) 941-8538

851 S Willow Ave
Ste 112
Cookeville, TN 38501
Phone (615) 941-8538

405 Steam Plant Rd
Ste 200
Gallatin, TN 37066
Phone (615) 445-3774

3024 Business Park Cir
Goodlettsvlle, TN 37072
Phone (615) 239-2018

320 New Shackle Island Rd
Hendersonville, TN 37075

40 W Caldwell St
Ste 200
Mt Juliet, TN 37122
Phone (615) 553-5640

1547 Warrior Dr
Ste A
Murfreesboro, TN 37128
Phone (615) 941-8538

3443 Dickerson Pike
Ste 400
Nashville, TN 37207
Phone (615) 612-2146

2222 State St
Ste C
Nashville, TN 37203
Phone (615) 329-0131

300 20th Ave N
Ste 600
Nashville, TN 37203
Phone (615) 284-2214

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 12

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": "1338940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677024000000",
    "number": "1609137587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-239-2018",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 S WILLOW AVE STE 112",
            "city": "COOKEVILLE",
            "state": "TN",
            "postal_code": "385014222",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "776 Weatherly Dr Ste B",
            "address_purpose": "LOCATION",
            "city": "Clarksville",
            "state": "TN",
            "postal_code": "370438922",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5801 Crossings Blvd",
            "address_purpose": "LOCATION",
            "city": "Antioch",
            "state": "TN",
            "postal_code": "370133130",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1547 Warrior Dr Ste A",
            "address_purpose": "LOCATION",
            "city": "Murfreesboro",
            "state": "TN",
            "postal_code": "371280922",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1642 Westgate Cir Ste 201",
            "address_purpose": "LOCATION",
            "city": "Brentwood",
            "state": "TN",
            "postal_code": "370278587",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2222 State St Ste C",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372031869",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 20th Ave N Ste 600",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372032143",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "320 New Shackle Island Rd",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "TN",
            "postal_code": "370752312",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Steam Plant Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Gallatin",
            "state": "TN",
            "postal_code": "370663375",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 W Caldwell St Ste 200",
            "address_purpose": "LOCATION",
            "city": "MT Juliet",
            "state": "TN",
            "postal_code": "371223179",
            "country_code": "US",
            "telephone_number": "615-941-8501",
            "fax_number": "615-941-8102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ANGELA",
        "middle_name": "DANIELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-06",
        "last_updated": "2023-02-22",
        "certification_date": "2023-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "16830",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "16830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "LAMBETH",
            "middle_name": "DANIELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cookeville, TN

Sources for this page

Verify at the official NPI Registry.