Bridgett Moore, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

39418 Issued in GA

Practice address

2810 N Oak St
Valdosta, GA 31602-1716

Phone

(229) 259-0019

Fax

(229) 259-0209

NPI assigned

Aug 5, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Plastic and Reconstructive Surgery

Education

Emory University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• SGMC Health Hospital, Valdosta, GA, CCN 110122

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AEAJCA/Endpoint/AEAJCA

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.

• Azalea Center for Plastic Surgery PC

  • Specialist
  • Valdosta, GA
  • NPI 1952431223
  Medicare reassignment NPD Authorized official
• Azalea Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Valdsota, GA
  • NPI 1467664268
  NPD Authorized official
• Hospital Authority of the City of Bainbridge and Decatur County

  dba Memorial Hospital and Manor

  • Multi-Specialty Clinic/Center
  • Bainbridge, GA
  • NPI 1053388256

  Single Specialty

  NPD (past)

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

• South Georgia Medical Center Inc

  dba SGMC Health

  • General Acute Care Hospital
  • Valdosta, GA
  • NPI 1144096553
  Care Compare affiliation

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427328000000",
    "number": "1679764757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-259-0019",
            "fax_number": "229-259-0209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 N OAK ST",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316021716",
            "telephone_number": "229-259-0019",
            "fax_number": "229-259-0209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "BRIDGETT",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-05",
        "last_updated": "2015-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "39418",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GA PROVIDER #",
            "identifier": "598880",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00830277A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR PROVIDER #",
            "identifier": "110206439",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Moon, DPT
• Adam Rhett Moore, PHARMD
• Adrienne L Moore
• Amanda Martin Moore, D.P.T., OT
• Barbara Ann Moore, LMFT
• Daphne Moore
• Hannah Moore, PMHNP-BC
• Joseph Moore, MSPT
• Justin Moore, LMFT
• Kaitlyn E. Moore, NP-C

• Specialist in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2015; 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.