Lacie Stafford Moore, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200503 Issued in LA

Practice address

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902

Phone

(337) 521-9127

NPI assigned

Oct 11, 2011

Last updated

Mar 17, 2018By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Physician Assistant

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Check Point Urgent CareGroup PAC ID 8426394628, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/caldmem-57e7c173

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.

• Check Point Urgent Care

  • Urgent Care Clinic/Center
  • New Iberia, LA
  • NPI 1932696812
  Medicare reassignment Care Compare group
• Pediatric Group of Acadiana, LLC

  • Specialist
  • Lafayette, LA
  • NPI 1265499628
  Medicare reassignment NPD (past)
• Acadiana Acute Care Associates, LLC

  • Emergency Medicine Physician
  • Lafayette, LA
  • NPI 1255566626
  Medicare reassignment
• Caldwell Memorial Hospital, Inc.

  • Emergency Medicine Physician
  • Columbia, LA
  • NPI 1023283793
  Medicare reassignment
• Check Point Urgent Care of Crowley LLC

  • Urgent Care Clinic/Center
  • Crowley, LA
  • NPI 1750822151
  Medicare reassignment
• St Martin Emergency Group LLC

  • Emergency Medicine Physician
  • Breaux Bridge, LA
  • NPI 1710231774
  Medicare reassignment
• WK Urgent Care Center-Pierremont

  • Family Medicine Physician
  • Shreveport, LA
  • NPI 1639115132
  Medicare reassignment
• Caldwell Memorial Hospital, Inc

  dba Chatham Rural Health Clinic

  • Rural Health Clinic/Center
  • Chatham, LA
  • NPI 1114222072
  NPD
• Check Point Urgent Care

  • Urgent Care Clinic/Center
  • Opelousas, LA
  • NPI 1952952061
  NPD
• Pediatric Group of Acadiana LLC

  dba Kaplan Family Care Clinic

  • Rural Health Clinic/Center
  • Kaplan, LA
  • NPI 1922619238
  NPD
• Pediatric Group of Acadiana, LLC

  dba St. Martinville Maternal-Child Clinic

  • Rural Health Clinic/Center
  • Saint Martinville, LA
  • NPI 1922283225
  NPD
• Check Point Primary Care LLC

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1215767454

  Physician Assistant

  NPD (past)

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

{
    "created_epoch": "1318291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1760767610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4600 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086902",
            "telephone_number": "337-521-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086902",
            "telephone_number": "337-521-9127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Hospital Dr",
            "address_2": "Suite 180",
            "address_purpose": "LOCATION",
            "city": "Bossier City",
            "state": "LA",
            "postal_code": "711112394",
            "country_code": "US",
            "telephone_number": "318-212-7520",
            "fax_number": "318-212-7519",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "LACIE",
        "middle_name": "STAFFORD",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-11",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200503",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE NUMBER",
            "identifier": "PA.200503",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Moore Wellness, LLC
• Bria Moore, PHARM. D
• Emily Jean Moore
• Jennifer Moore, M.S., LPC
• Keyonna Chavontrel Moore
• Mary Moore, LPC
• Matthew Moore, MD
• Patrick Devincent Moore, M.D.
• Payton Anne Moore
• Shawntel Marie Moore, ARNP, FNP-C

• Physician Assistant in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.