NPIMap

Individual provider Active NPI

Mark E Moran, PA-C

  • Physician Assistant
  • Boones Mill, VA
National Provider Identifier
1609821677
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0110001699 Issued in VA
Practice address
22890 Virgil H Goode Hwy
Boones Mill, VA 24065
Phone
(540) 334-5511
NPI assigned
May 24, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 0110001699 VA Primary
Medical Physician Assistant 363AM0700X 0110001699 VA

Addresses

Primary practice location

22890 Virgil H Goode Hwy
Boones Mill, VA 24065

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

142 S Main St
Emergency Dept
Danville, VA 24541-2922
Phone (434) 799-2222

Other identifiers 1

IdentifierTypeStateIssuer
010010942MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20050203000354 VA Practitioner - Physician Assistant 1759332018 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
University of Nebraska College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Coverage LLCGroup PAC ID 3072412592, 761 clinicians
Carilion Giles Community HospitalGroup PAC ID 3678670221, shared by 17 NPIs, 223 clinicians

Practice addresses (Care Compare)

142 S Main St
Danville, VA 24541-2922
Phone (434) 799-2100

22890 Virgil Goode Hwy
Boones Mill, VA 24065
Phone (540) 334-5511

6801 Gov G C Peery Hwy
Richlands, VA 24641
Phone (276) 596-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Carilion Giles Community Hospital CurrentSince Jan 11, 2026 Accepting new patients
Carilion Giles Community Hospital CurrentSince Jan 11, 2026 Accepting new patients
Danville Emergency Group LLC Medical Past Accepting new patients
Danville Emergency Physicians, PC Past Accepting new patients
Sterling Emergency Services of Virginia Inc Past Accepting new patients
Ecs of Virginia, Inc. Past Accepting new patients

Locations

200 Hospital Dr
Galax, VA 24333
Phone (276) 236-6011

159 Hartley Way
Pearisburg, VA 24134
Phone (540) 921-6000

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1609821677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22890 VIRGIL H GOODE HWY",
            "city": "BOONES MILL",
            "state": "VA",
            "postal_code": "24065",
            "telephone_number": "540-334-5511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "142 S Main St",
            "address_2": "Emergency Dept",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "VA",
            "postal_code": "245412922",
            "country_code": "US",
            "telephone_number": "434-799-2222",
            "fax_number": "434-799-3857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MORAN",
        "first_name": "MARK",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2026-07-13",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VA",
            "license": "0110001699",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "VA",
            "license": "0110001699",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010010942",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boones Mill, VA

Sources for this page

Verify at the official NPI Registry.