Individual provider Active NPI

Lauren Renea Moore, MD

  • Emergency Medicine Physician
  • Fort Walton Beach, FL
National Provider Identifier
1619464435
Registry record updated Aug 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
ME148566 Issued in FL
Practice address
1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone
(850) 862-1111
NPI assigned
Apr 17, 2018
Last updated
Aug 8, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME148566 FL Primary

Addresses

Primary practice location

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708

Mailing address

1000 Mar Walt Dr
Fort Walton Beach, FL 32547-6708
Phone (850) 862-1111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210506002910 FL Practitioner - Emergency Medicine 8123377793 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Alabama School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Medicine Services of FL LLCGroup PAC ID 8426413931, 686 clinicians
Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

1000 Mar Walt Dr
Fort Walton Beach Medical Center
Fort Walton Beach, FL 32547-6708
Phone (850) 864-0213

7800 US Hwy 98 W
Miramar Beach, FL 32550-7228
Phone (850) 278-3000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.3 of 100Reported as group
Quality
70.94
Improvement activities
40
Cost
92.94

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME148566FLMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Medicine Services of FL, LLC Emergency Medicine CurrentSince Apr 1, 2023 Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 9, 2024 Accepting new patients
Cep America, LLC Emergency Medicine Current Accepting new patients
Cep America LLC Emergency Medicine CurrentSince Apr 9, 2024 Accepting new patients
Blue Job Emergency Physicians LLC Emergency Medicine Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

322 SW Pine Island Rd
Cape Coral, FL 33991
Phone (941) 249-6858

200 Tequesta Dr
Destin, FL 32541
Phone (850) 837-9194

1000 Mar Walt Dr
Ft Walton Bch, FL 32547
Phone (850) 374-9610

20900 Biscayne Blvd
Miami, FL 33180
Phone (305) 682-7290

7800 US Highway 98 W
Miramar Beach, FL 32550
Phone (850) 267-1603

1809 Granada St
Navarre, FL 32566
Phone (850) 684-6200

105 Tamiami Trl
Fl Tamiami
Port Charlotte, FL 33953

14000 Fivay Rd
Port Richey, FL 34667
Phone (727) 819-2929

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Organizations & group practices 5

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 2

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": "1523923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628380800000",
    "number": "1619464435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 MAR WALT DR",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476708",
            "telephone_number": "850-862-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LAUREN",
        "middle_name": "RENEA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-17",
        "last_updated": "2021-08-08",
        "certification_date": "2021-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME148566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.