Cadeatrizlius Shawnquitia Moore, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-126814 Issued in AL

Practice address

22136 Medical Village Dr
Athens, AL 35613-2940

Phone

(256) 648-5598

NPI assigned

Nov 20, 2019

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

Locations

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.

• Hometown Pediatrics LLC

  • Pediatrics Physician
  • Athens, AL
  • NPI 1669091120
  NPD
• Athens Pediatrics

  • Pediatrics Physician
  • Huntsville, AL
  • NPI 1407043102
  NPD (past)

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1639715006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22136 MEDICAL VILLAGE DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132940",
            "telephone_number": "256-648-5598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22136 MEDICAL VILLAGE DR",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132940",
            "telephone_number": "256-648-5598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CADEATRIZLIUS",
        "middle_name": "SHAWNQUITIA",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2024-11-05",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-126814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaycee Mitchell
• Jeff Mitchell, NP
• Terri Monroe
• Mason Anthony Montney, PT, DPT
• Gregg Philip Moody, MD
• Darby Elizabeth Moore
• Douglas B Moore, MD
• Haley Moore, BA
• Jamia Moore, DNP, APRN, CRNA
• Lindsey Brooke Moore, COTA

• Family Nurse Practitioner in Athens, AL
• Providers in Athens, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; 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.