Ellen Peyton Moore, DNP, APRN, AGPCNP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

901499 Issued in MS

Practice address

122 Weisenberger Rd
Madison, MS 39110-7993

Phone

(601) 790-9098

NPI assigned

Jan 12, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Montgomery Family Clinic

  • Primary Care Clinic/Center
  • Madison, MS
  • NPI 1235429648
  NPD (past)
• Raleigh Family Health Clinic PLLC

  • Primary Care Clinic/Center
  • Bay Springs, MS
  • NPI 1497173942
  NPD (past)

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

{
    "created_epoch": "1484179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1639615768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 WEISENBERGER RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107993",
            "telephone_number": "601-790-9098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 WEISENBERGER RD",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391107993",
            "telephone_number": "601-790-9098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELLEN",
        "middle_name": "PEYTON",
        "credential": "DNP, APRN, AGPCNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-12",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "901499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Britton Montgomery, D.M.D., M.S.D
• Joseph Brooks Montgomery, MD
• Latrena Montgomery, FNP-C
• Susan Leigh Montgomery, FNP
• Elizabeth Bryce Mooney, PT
• Lee Ellis Moore, M.D.
• Morgan Moore, NP
• More MD LLC
• More Than Words, LLC
• Melanie L Moreau, LCSW

• Adult Health Nurse Practitioner in Madison, MS
• Providers in Madison, MS by specialty
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.