Whitney Lee Moore, DNP, PMHNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

ID-58820 Issued in ID

Practice address

1675 Curlew Dr
Ammon, ID 83406-4850

Phone

(208) 523-5319

Fax

(208) 523-5627

NPI assigned

Jun 10, 2021

Sex

Female

Sole proprietor

No

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.

• 4 Pillars of Success LLC

  • Multi-Specialty Clinic/Center
  • Ammon, ID
  • NPI 1619134277
  Medicare reassignment Care Compare group NPD CLINICAL · ID
• 4 Pillars of Success LLC

  • Clinic/Center
  • Ammon, ID
  • NPI 1457698565
  NPD
• 4 Pillars of Success LLC

  • Clinic/Center
  • Ammon, ID
  • NPI 1992487615
  NPD CLINICAL

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

• Lost Rivers Medical Center

  • Critical Access Hospital
  • Arco, ID
  • NPI 1114925047
  Care Compare affiliation Hospital

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

4 Pillars of Success LLC 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324

Medicare fee-for-service enrollment

Enrolled in ID

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 5, 2021.

{
    "created_epoch": "1623283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633392000000",
    "number": "1770150484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2106",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834032106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 CURLEW DR",
            "city": "AMMON",
            "state": "ID",
            "postal_code": "834064850",
            "telephone_number": "208-523-5319",
            "fax_number": "208-523-5627"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "WHITNEY",
        "middle_name": "LEE",
        "credential": "DNP, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-10",
        "last_updated": "2021-10-05",
        "certification_date": "2021-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "ID",
            "license": "ID-58820",
            "primary": true
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "ID",
            "license": "ID-58820",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Raintree",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "address_1": "1675 Curlew Dr",
            "city": "Ammon",
            "state": "ID",
            "country_code": "US",
            "postal_code": "834064850",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kimberly Moffat
• Darryl G Moffett Jr., M.D.
• Gary Mondell, RPH
• Bridget Christine Moore, RN
• Joseph Reed Moore, M.D.
• Jocelyn Morgan
• Tucker Mortensen
• Gerald Elbert Mortimer, M.D.
• Mr. Phillips Hearing Center, Inc.
• Lawrance Nai

• All providers in Ammon, ID
• Psychiatric/Mental Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.