Mallory Butler Moore, CRNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

1-149936 Issued in AL

Practice address

101 Sivley Rd SW
Huntsville, AL 35801-4470

Phone

(256) 265-1000

NPI assigned

May 11, 2021

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

Medicare fee-for-service enrollment

Enrolled in AL

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

Specialty

Nurse Practitioner

Education

University of Alabama School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alabama Colon and Gastro PCGroup PAC ID 8820394026, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huntsville Hospital Hospital, Huntsville, AL, CCN 010039
• Crestwood Medical Center Hospital, Huntsville, AL, CCN 010131

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/EGJDAD

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.

• Alabama Colon & Gastro, PC

  • Gastroenterology Physician
  • Huntsville, AL
  • NPI 1437514684
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Crestwood Healthcare LP

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1023061496
  Care Compare affiliation
• The Health Care Authority of the City of Huntsville

  • General Acute Care Hospital
  • Huntsville, AL
  • NPI 1447221056
  Care Compare affiliation

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

{
    "created_epoch": "1620691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620691200000",
    "number": "1740864180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7832 HORSESHOE TRL SE",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358023218",
            "telephone_number": "256-457-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 SIVLEY RD SW",
            "city": "HUNTSVILLE",
            "state": "AL",
            "postal_code": "358014470",
            "telephone_number": "256-265-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MALLORY",
        "middle_name": "BUTLER",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-11",
        "last_updated": "2021-05-11",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "AL",
            "license": "1-149936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iva Moore
• Jacob Evans Moore
• Jessica Nicole Moore, COTA
• Jordan Alexander Moore
• Kristine Moore, CRNP
• Nicole Cecelia Moore
• Ray Jemison Moore III, M.D.
• Sandra Moore, PT, PHD
• Sara Beth Moore
• Shimena Renae Moore, LMSW

• Nurse Practitioner in Huntsville, AL
• Providers in Huntsville, AL by specialty
• Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2021; 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.

Verify at the official NPI Registry.