Individual provider Active NPI

Elizabeth Michelle Moore, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Louisa, KY
National Provider Identifier
1710751516
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3018614 Issued in KY
Practice address
125 S Main Cross St
Louisa, KY 41230-1065
Phone
(606) 638-0938
NPI assigned
Nov 13, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3018614 KY Primary

Addresses

Primary practice location

125 S Main Cross St
Louisa, KY 41230-1065

Mailing address

125 S Main Cross St
Louisa, KY 41230-1065
Phone (606) 638-0938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TN, VA, WV4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20250124002071 KY Practitioner - Nurse Practitioner 4082143771 Reassigns benefits to 1 organization
I20250206000124 TN Practitioner - Nurse Practitioner 4082143771 Reassigns benefits to 1 organization
I20250314003355 VA Practitioner - Nurse Practitioner 4082143771 Reassigns benefits to 1 organization
I20250719000174 WV Practitioner - Nurse Practitioner 4082143771 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Hopkins Medical Association LLCGroup PAC ID 3476983040, 11 clinicians

Practice addresses (Care Compare)

1616 Mountaineer Hwy
Bradshaw, WV 24817
Phone (276) 598-4448

206 Ky Rd
RT 979
Harold, KY 41635-9046
Phone (606) 478-2144

3955 W Andrew Johnson Hwy
Morristown, TN 37814-1103
Phone (276) 598-4448

460 Front St
Richlands, VA 24641-3065
Phone (276) 598-4448

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Hopkins Medical Association LLC CurrentSince Jan 1, 2025 Accepting new patients
Savida Health, PC PastSince Feb 1, 2025 Accepting new patients
Wynn Medical Center Past Accepting new patients

Locations

206 Ky Route 979
Harold, KY 41635
Phone (606) 437-4100

3955 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (844) 444-6754

3359 Linden Dr
Bristol, VA 24202
Phone (276) 494-0230

1014 Park Ave NW
Norton, VA 24273
Phone (276) 679-0800

177 Dollar Dr
Ste A
Pennington Gap, VA 24277
Phone (276) 318-0414

460 Front St
Richlands, VA 24641
Phone (304) 967-5919

310 George St
Beckley, WV 25801
Phone (304) 254-9022

511 Blue Prince Rd
Bluefield, WV 24701
Phone (304) 327-0723

1255 Vinus St
Gilbert, WV 25621
Phone (304) 664-8883

781 Virginia Ave
Welch, WV 24801
Phone (304) 436-6360

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699833600000",
    "number": "1710751516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ELIZABETH",
        "middle_name": "MICHELLE",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

Verify at the official NPI Registry.