Holly S Moore

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

4704222396 Issued in MI

Practice address

5200 Anthony Wayne Dr
Suite 115
Detroit, MI 48202-3945

Phone

(313) 577-5041

NPI assigned

May 17, 2013

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

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Beaumont Medical Group- Specialty ServicesGroup PAC ID 7214299866, 868 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Merit-based Incentive Payment System (MIPS)

Final score

84.37 of 100Reported as group

Quality

66.73

Promoting interoperability

100

Improvement activities

40

Cost

70.98

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: hmoore1457860@epic00.shdirect.org

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.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment Care Compare group NPD
• Nursing Practice Corporation

  dba Campus Health Center

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1023180106
  NPD (past)
• Nursing Practice Corporation

  dba Taylor Street Primary Care Clinic

  • Nurse Practitioner
  • Detroit, MI
  • NPI 1629616511
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1368748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368748800000",
    "number": "1649616525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 ANTHONY WAYNE DR",
            "address_2": "SUITE 115",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 ANTHONY WAYNE DR",
            "address_2": "SUITE 115",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482023945",
            "telephone_number": "313-577-5041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "HOLLY",
        "middle_name": "S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-17",
        "last_updated": "2013-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MI",
            "license": "4704222396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donald R Moore, LLMSW CAAC
• Duane Moore
• Ebony Moore, RN
• Geneva Moore
• Gonzalus Orell Moore, RPH
• Janise Moore
• Johnzell Deangelo Moore Jr.
• June L. Moore, PHARMACIST
• Ladawna Moore
• Lashauna Donise Moore

• Adult Health Nurse Practitioner in Detroit, MI
• Providers in Detroit, MI by specialty
• Adult Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.