NPIMap

Individual provider Active NPI

Carolyn Anne Moore, PA-C

  • Physician Assistant
  • Louisville, KY
National Provider Identifier
1760765317
Registry record updated Jan 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1686 Issued in KY
Practice address
3 Audubon Plaza Dr
Ste.560
Louisville, KY 40217-1300
Phone
(502) 636-8004
Fax
(502) 636-8384
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X TC080 KY
Physician Assistant 363A00000X PA1686 KY Primary

Addresses

Primary practice location

3 Audubon Plaza Dr
Ste.560
Louisville, KY 40217-1300

Mailing address

PO Box 776351
Chicago, IL 60677-6351
Phone (502) 588-9490

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cmoore78359@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000172 KY Practitioner - Physician Assistant 8729246921 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Medical Associates IncGroup PAC ID 7012811284, 1,368 clinicians

Practice addresses (Care Compare)

1 Audubon Plaza Dr
Louisville, KY 40217-1318
Phone (502) 636-7225

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 893-1270

4950 Norton Healthcare Blvd
Louisville, KY 40241-2848

4960 Norton Healthcare Blvd
Louisville, KY 40241-2831
Phone (502) 446-8125

825 Barret Ave
Louisville, KY 40204-1743
Phone (502) 272-5165

Hospital & facility affiliations

  • Norton Hospitals, Inc Hospital, Louisville, KY, CCN 180088

Merit-based Incentive Payment System (MIPS)

Final score
81.11 of 100Reported as group
Quality
63.34
Promoting interoperability
100
Improvement activities
40
Cost
73.68

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
TC080KYMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Community Medical Associates, Inc. CurrentSince Jan 1, 2015 Accepting new patients
Community Medical Associates, Inc. Physician Assistant CurrentSince Jan 1, 2015 Accepting new patients

Locations

4950 Norton Healthcare Blvd
Ste 300
Louisville, KY 40241
Phone (502) 394-6350

3 Audubon Plaza Dr
Ste 560
Louisville, KY 40217
Phone (502) 636-8004

825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165

Interoperability endpoints

  • Direct secure messaging: cmoore78359@direct.nortonhealthcare.org

Organizations & group practices 2

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.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611100800000",
    "number": "1760765317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776351",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776351",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 AUDUBON PLAZA DR",
            "address_2": "STE.560",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402171300",
            "telephone_number": "502-636-8004",
            "fax_number": "502-636-8384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CAROLYN",
        "middle_name": "ANNE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2021-01-20",
        "certification_date": "2021-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "TC080",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cmoore78359@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "3 Audubon Plaza Dr",
            "address_2": "Ste.560",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402171300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/",
            "affiliation": "N",
            "address_1": "3 Audubon Plaza Dr",
            "address_2": "Ste.560",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402171300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.