Individual provider Active NPI

Hope B Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Jackson, TN
National Provider Identifier
1619963295
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN0000025857 Issued in TN
Practice address
207 Stonebridge Blvd
Jackson, TN 38305-2040
Phone
(731) 661-6340
NPI assigned
Sep 20, 2005
Last updated
Apr 4, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN0000025857 TN Primary

Addresses

Primary practice location

207 Stonebridge Blvd
Jackson, TN 38305-2040

Mailing address

303 Parkburg Rd
Jackson, TN 38301-9527
Phone (573) 686-5550

Other identifiers 2

IdentifierTypeStateIssuer
3605910MedicaidTN
3022807OtherTNTN BCBS INDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN0000025857TNMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Surgery Center Anesthesia PLLC Nurse Anesthetist, Certified Registered PastSince Mar 31, 2008 Accepting new patients
Professional Anesthesia Associates Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1619963295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 PARKBURG RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383019527",
            "telephone_number": "573-686-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 STONEBRIDGE BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052040",
            "telephone_number": "731-661-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HOPE",
        "middle_name": "B",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-20",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "RN0000025857",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3605910",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN BCBS INDIVIDUAL",
            "identifier": "3022807",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.