Pamela Lynn Moore, RN FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

Practice address

7600 N 15TH Street
#130
Phoenix, AZ 85020-4347

Phone

(602) 861-1611

Fax

(602) 371-8929

NPI assigned

Aug 14, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

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.

• Mountain Park Health Center - Dental

  • Federally Qualified Health Center (FQHC)
  • Phoenix, AZ
  • NPI 1710146188
  NPD (past)
• Pediatric Associates PC

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1194810127
  NPD (past)

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730192246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7600 N 15TH STREET",
            "address_2": "#130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204347",
            "telephone_number": "602-861-1611",
            "fax_number": "602-371-8929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7600 N 15TH STREET",
            "address_2": "#130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850204347",
            "telephone_number": "602-861-1611",
            "fax_number": "602-371-8929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "PAMELA",
        "middle_name": "LYNN",
        "credential": "RN FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AZ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "648850",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mercedes Moore
• Michael Moore, CCP
• Michael Moore
• Monica Moore
• Natalie Jean Moore, MD
• Raquel Moore
• Richard H Moore, M.D.
• Rohan T Moore
• Roslyn Moore
• Sandra Moore

• Nurse Practitioner in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.