Individual provider Active NPI

Deborah Dobrota Moyer, APRN

  • Adult Health Nurse Practitioner
  • Little River, SC
National Provider Identifier
1740598432
Registry record updated Aug 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
19030 Issued in SC
Practice address
4303 Live Oak Dr
Little River, SC 29566-9138
Phone
(843) 663-8000
NPI assigned
Sep 16, 2010
Last updated
Aug 29, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2019

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 5006546 NC
Adult Health Nurse Practitioner 363LA2200X 19030 SC Primary
Gerontology Nurse Practitioner 363LG0600X 19030 SC
Gerontology Nurse Practitioner 363LG0600X 5006546 NC

Addresses

Primary practice location

4303 Live Oak Dr
Little River, SC 29566-9138

Mailing address

PO Box 547
Little River, SC 29566-0547
Phone (843) 663-8000

Other identifiers 1

IdentifierTypeStateIssuer
NP2548MedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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

Enrollment IDStateProvider typePAC IDDetails
I20141120002306 SC Practitioner - Nurse Practitioner 3173706835 Reassigns benefits to 6 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
19030SCMDAdult Health Nurse Practitioner
5006546NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Little River Medical Center, Inc. CurrentSince Mar 6, 2017 Accepting new patients
Little River Medical Center, Inc CurrentSince Mar 1, 2016 Accepting new patients
Little River Medical Center, Inc. CurrentSince Feb 27, 2017 Accepting new patients
Little River Medical Center, Inc. CurrentSince Jan 1, 2017 Accepting new patients
Little River Medical Center Inc CurrentSince Sep 15, 2014 Accepting new patients

Locations

4303 Live Oak Dr
Little River, SC 29566
Phone (803) 839-3939

3817 Main St
Loris, SC 29569
Phone (843) 663-8297

3515 Caduceus Dr
Ste B
Myrtle Beach, SC 29588
Phone (843) 651-5689

4220 Carolina Exchange Dr
Myrtle Beach, SC 29579
Phone (843) 663-8013

7724 N Kings Hwy
Myrtle Beach, SC 29572
Phone (843) 839-3939

Interoperability endpoints

  • Direct secure messaging: deborahmoyer@imaa.allscriptsdirect.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567036800000",
    "number": "1740598432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 547",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295660547",
            "telephone_number": "843-663-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4303 LIVE OAK DR",
            "city": "LITTLE RIVER",
            "state": "SC",
            "postal_code": "295669138",
            "telephone_number": "843-663-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOYER",
        "first_name": "DEBORAH",
        "middle_name": "DOBROTA",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-16",
        "last_updated": "2019-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "5006546",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "SC",
            "license": "19030",
            "primary": true
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "SC",
            "license": "19030",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "5006546",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NP2548",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Little River, SC

Sources for this page

Verify at the official NPI Registry.