Active NPI
Haley Moore, PA-C
- Physician Assistant
- Anna, IL
National Provider Identifier
1720701576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 085009259
- Practice address
- 513 N Main St
Anna, IL 62906-1697 - Phone
- (618) 833-4471
- Fax
- (618) 833-6267
- NPI assigned
- Sep 26, 2022
- Last updated
- Nov 13, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 085009259 | IL | Primary |
Addresses
Primary practice location
513 N Main St
Anna, IL 62906-1697
Mailing address
513 N Main St
Anna, IL 62906-1697
Phone (618) 833-4471
Other practice location 1
13245 Kessler Rd
Cairo, IL 62914-3101
Phone (618) 734-4400
Other practice location 2
1340 Cedar Ct
Carbondale, IL 62901-5336
Phone (618) 457-7821
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | haley.inmanp1@direct.chesi.nextgenshare.com | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Southern Illinois University School of Medicine, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
513 N Main St
Anna, IL 62906-1668
Phone (618) 833-4471
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rural Health, Inc. | Current | Accepting new patients | |
| Rural Health, Inc. | Current | Accepting new patients | |
| Rural Health, Inc. | Past | Accepting new patients | |
| Rural Health, Inc. | Past | Accepting new patients |
Locations
513 N Main St
Anna, IL 62906
Phone (618) 833-4471
Interoperability endpoints
- haley.moore.1@7601.direct.athenahealth.com
Organizations & group practices 4
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.
-
- Federally Qualified Health Center (FQHC)
- Anna, IL
- NPI 1982666384
-
dba Dongola Medical Clinic
- Federally Qualified Health Center (FQHC)
- Dongola, IL
- NPI 1366506628
-
dba Vienna Medical Clinic
- Federally Qualified Health Center (FQHC)
- Vienna, IL
- NPI 1932263332
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Deaconess Illinois Union County
- Critical Access Hospital
- Anna, IL
- NPI 1710604483
-
dba Memorial Hospital of Carbondale
- General Acute Care Hospital
- Carbondale, IL
- NPI 1093801797
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1664150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1699833600000",
"number": "1720701576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "513 N MAIN ST",
"city": "ANNA",
"state": "IL",
"postal_code": "629061697",
"telephone_number": "618-833-4471",
"fax_number": "618-833-6267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "513 N MAIN ST",
"city": "ANNA",
"state": "IL",
"postal_code": "629061697",
"telephone_number": "618-833-4471",
"fax_number": "618-833-6267"
}
],
"practiceLocations": [
{
"address_1": "13245 Kessler Rd",
"address_purpose": "LOCATION",
"city": "Cairo",
"state": "IL",
"postal_code": "629143101",
"country_code": "US",
"telephone_number": "618-734-4400",
"fax_number": "618-477-8557",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1340 Cedar Ct",
"address_purpose": "LOCATION",
"city": "Carbondale",
"state": "IL",
"postal_code": "629015336",
"country_code": "US",
"telephone_number": "618-457-7821",
"fax_number": "618-529-3862",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MOORE",
"first_name": "HALEY",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-09-26",
"last_updated": "2023-11-13",
"certification_date": "2023-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "IL",
"license": "085009259",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "haley.inmanp1@direct.chesi.nextgenshare.com",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "1340 Cedar Ct",
"city": "Carbondale",
"state": "IL",
"country_code": "US",
"postal_code": "629015336",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Anna, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; 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.