Individual provider Active NPI

Cheryl Stewart Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Salisbury, NC
National Provider Identifier
1760414924
Registry record updated Nov 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
45272 Issued in NC
Practice address
612 Mocksville Ave
Salisbury, NC 28144-2732
Phone
(704) 210-5661
NPI assigned
Jul 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 45272 NC Primary

Addresses

Primary practice location

612 Mocksville Ave
Salisbury, NC 28144-2732

Mailing address

265 N 3Rd St
Albemarle, NC 28001-4011
Phone (704) 985-0144

Other identifiers 2

IdentifierTypeStateIssuer
P00117358OtherNCRR MEDICARE
8050664MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518001542 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 0345231429 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
45272NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinaeast Medical Center CurrentSince Dec 1, 2008 Accepting new patients
Carolinaeast Medical Center Nurse Anesthetist, Certified Registered CurrentSince Dec 1, 2008 Accepting new patients
Wake Forest University Health Sciences CurrentSince Feb 23, 2021 Accepting new patients
East Carolina Anesthesia Associates, PLLC Anesthesiology CurrentSince Dec 9, 2024 Accepting new patients
Digestive Health Endoscopy Center Anesthesiology CurrentSince Feb 18, 2019 Accepting new patients
Lighthouse Anesthesia LLC Anesthesiology Past Accepting new patients
Cabarrus Memorial Hospital Past Accepting new patients
Novant Health Rowan Medical Center LLC Past Accepting new patients

Locations

1001 W Williams St
Ste 103
Apex, NC 27502
Phone (919) 363-2111

920 Church St N
Ste 300
Concord, NC 28025
Phone (704) 783-4235

920 Church St N
Concord, NC 28025
Phone (704) 403-3000

3202 Boone Trl
Fayetteville, NC 28306
Phone (910) 223-7011

2430 Emerald Pl
Ste 103
Greenville, NC 27834
Phone (252) 752-2140

3714 Guardian Ave
Ste W
Morehead City, NC 28557
Phone (252) 247-0314

2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104

612 Mocksville Ave
Salisbury, NC 28144
Phone (704) 210-5000

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730764800000",
    "number": "1760414924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 N 3RD ST",
            "city": "ALBEMARLE",
            "state": "NC",
            "postal_code": "280014011",
            "telephone_number": "704-985-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "612 MOCKSVILLE AVE",
            "city": "SALISBURY",
            "state": "NC",
            "postal_code": "281442732",
            "telephone_number": "704-210-5661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHERYL",
        "middle_name": "STEWART",
        "name_prefix": "Mrs.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-11-05",
        "certification_date": "2024-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "45272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00117358",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8050664",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.