Individual provider Active NPI

Chadd Jason Moore, CRNA

  • Certified Registered Nurse Anesthetist
  • Hendersonville, NC
National Provider Identifier
1780628180
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
11099 Issued in TN
Practice address
100 Hospital Dr
Hendersonville, NC 28792-5272
Phone
(828) 681-2420
Fax
(828) 687-0729
NPI assigned
Jun 15, 2006
Last updated
Apr 4, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 70304 NC
Certified Registered Nurse Anesthetist 367500000X 11099 TN Primary

Addresses

Primary practice location

100 Hospital Dr
Hendersonville, NC 28792-5272

Mailing address

PO Box 1869
Fletcher, NC 28732-1869
Phone (828) 687-5616

Other identifiers 7

IdentifierTypeStateIssuer
10069833OtherTNAMERIGROUP
4081901OtherTNBCBS
74010612OtherKYKY MEDICAID
P01263433OtherNCMEDICARE RR
181WMOtherNCBCBS NC
P00162074OtherTNRAILROAD MEDICARE
3629899MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, NC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040713001580 TN Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628056793 Reassigns benefits to 2 organizations
I20131001000405 NC Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628056793

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nashville Anesthesia PLLCGroup PAC ID 1557350501, 62 clinicians

Practice addresses (Care Compare)

200 Stonecrest Blvd
Smyrna, TN 37167-6810
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
11099TNMDInternal Medicine Physician
70304NCMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Nashville Anesthesia PLLC Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2021 Accepting new patients
American Anesthesiology of Tennessee, P.C. Nurse Anesthetist, Certified Registered CurrentSince Apr 4, 2017 Accepting new patients
American Anesthesiology of Tennessee, P.C. CurrentSince Apr 4, 2017 Accepting new patients

Locations

1500 W Poplar Ave
Collierville, TN 38017
Phone (901) 227-8140

501 20th St
Ste 606
Knoxville, TN 37916
Phone (865) 331-2278

9300 Park West Blvd
Knoxville, TN 37923
Phone (865) 427-4040

397 Wallace Rd
Ste 407
Nashville, TN 37211
Phone (615) 832-5530

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Organizations & group practices 3

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 2

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": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491264000000",
    "number": "1780628180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1869",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287321869",
            "telephone_number": "828-687-5616",
            "fax_number": "828-650-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL DR",
            "city": "HENDERSONVILLE",
            "state": "NC",
            "postal_code": "287925272",
            "telephone_number": "828-681-2420",
            "fax_number": "828-687-0729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHADD",
        "middle_name": "JASON",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2017-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NC",
            "license": "70304",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "TN",
            "license": "11099",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10069833",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4081901",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KY MEDICAID",
            "identifier": "74010612",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P01263433",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NC",
            "identifier": "181WM",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00162074",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3629899",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.