Tracey D. Moore, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

175880851 Issued in WY

Practice address

214 E 23Rd St
Cheyenne Regional Medical Center, Emergency Dept.
Cheyenne, WY 82001-3748

Phone

(307) 634-2273

Fax

(307) 633-7671

NPI assigned

Sep 25, 2006

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Emergency Associates of Wyoming, LLC

  • Emergency Medicine Physician
  • Cheyenne, WY
  • NPI 1124041140
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1720188022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1241 W MINERAL AVE",
            "address_2": "SUITE 100",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801205685",
            "telephone_number": "303-759-0854",
            "fax_number": "303-759-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 E 23RD ST",
            "address_2": "CHEYENNE REGIONAL MEDICAL CENTER, EMERGENCY DEPT.",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820013748",
            "telephone_number": "307-634-2273",
            "fax_number": "307-633-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TRACEY",
        "middle_name": "D.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WY",
            "license": "175880851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "123828100",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "35177837",
            "state": "CO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "314502",
            "state": "WY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Michelle Montoya, RN
• Sydney Montoya
• Heather Jo Montross, LCSW
• Gabrielle Paige Moore, M.S., CCC-SLP
• Karla Rene Moore
• Angel Morado
• Melissa Morales-Burg
• Michael D More, DPM
• Maria L Mores, PSY.D., L.C.S.W.
• Sarah Morey, CLC

• Family Nurse Practitioner in Cheyenne, WY
• Providers in Cheyenne, WY by specialty
• Family Nurse Practitioner in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.