Individual provider Active NPI

Victoria Moore, APRN

  • Family Nurse Practitioner
  • Bradenton, FL
National Provider Identifier
1730865346
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11027168 Issued in FL
Practice address
5985 Silver Falls Run Ste 200
Bradenton, FL 34211-1291
Phone
(941) 907-4737
Fax
(941) 907-9493
NPI assigned
Jun 27, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11027168 FL Primary

Addresses

Primary practice location

5985 Silver Falls Run Ste 200
Bradenton, FL 34211-1291

Mailing address

PO Box 102222
Atlanta, GA 30368-2222
Phone (239) 274-8200

Other practice location 1

6547 Kenava Loop
Palmetto, FL 34221-2595
Phone (856) 265-3216

Other identifiers 1

IdentifierTypeStateIssuer
118983900MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230807000315 FL Practitioner - Nurse Practitioner 0345601449 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Cancer Specialists & Research Institute, LLC CurrentSince Jul 31, 2023 Accepting new patients

Locations

5985 Silver Falls Run
Ste 200
Bradenton, FL 34211
Phone (941) 907-4737

1970 Golf St
Fl Cancer
Sarasota, FL 34236
Phone (941) 795-3780

Organizations & group practices 1

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": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1730865346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102222",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682222",
            "telephone_number": "239-274-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5985 SILVER FALLS RUN STE 200",
            "city": "BRADENTON",
            "state": "FL",
            "postal_code": "342111291",
            "telephone_number": "941-907-4737",
            "fax_number": "941-907-9493"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6547 Kenava Loop",
            "address_purpose": "LOCATION",
            "city": "Palmetto",
            "state": "FL",
            "postal_code": "342212595",
            "country_code": "US",
            "telephone_number": "856-265-3216",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "VICTORIA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11027168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118983900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradenton, FL

Sources for this page

Verify at the official NPI Registry.