Active NPI
Alexandra Moore, MD
- Psychiatry Physician
- Charleston, SC
National Provider Identifier
1770328825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- LL92612
- Practice address
- 169 Ashley Avenue, Room 202 Muh, MSC 333
Charleston, SC 29425 - Phone
- (843) 792-2575
- NPI assigned
- Jun 29, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | LL92612 | SC | Primary |
Addresses
Primary practice location
169 Ashley Avenue, Room 202 Muh, MSC 333
Charleston, SC 29425
Mailing address
169 Ashley Avenue, Room 202 Muh, MSC 333
Charleston, SC 29425
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LL92612 | SC | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1719619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719619200000",
"number": "1770328825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "169 ASHLEY AVENUE, ROOM 202 MUH, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "169 ASHLEY AVENUE, ROOM 202 MUH, MSC 333",
"city": "CHARLESTON",
"state": "SC",
"postal_code": "29425",
"telephone_number": "843-792-2575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "ALEXANDRA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-06-29",
"last_updated": "2024-06-29",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "SC",
"license": "LL92612",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charleston, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2024; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.