Individual provider Active NPI

Teresa Lynn Moss, ARNP

  • Family Nurse Practitioner
  • Paducah, KY
National Provider Identifier
1780792937
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3002156 Issued in KY
Practice address
1532 Lone Oak Rd
Suite 415
Paducah, KY 42003-7913
Phone
(270) 442-0103
Fax
(270) 442-0109
NPI assigned
Aug 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3002156 KY Primary

Addresses

Primary practice location

1532 Lone Oak Rd
Suite 415
Paducah, KY 42003-7913

Mailing address

PO Box 636961
Cincinnati, OH 45263-6961
Phone (513) 981-5130

Other identifiers 2

IdentifierTypeStateIssuer
78001799MedicaidKY
P00947901OtherKYRAIL ROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20050112000887 KY Practitioner - Nurse Practitioner 9032168448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mercy Health Physicians Kentucky Specialty Care LLCGroup PAC ID 1456777069, 144 clinicians

Practice addresses (Care Compare)

1532 Lone Oak Rd
Suite 415
Paducah, KY 42003-7943
Phone (270) 442-0103

Hospital & facility affiliations

  • Mercy Health - Lourdes Hospital Hospital, Paducah, KY, CCN 180102

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3002156KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Mercy Health Physicians Kentucky Specialty Care LLC CurrentSince Sep 1, 2020 Accepting new patients
Cardiology Associates of Paducah, PSC Past Accepting new patients
Marshall County Medical Associates Past Accepting new patients

Locations

1532 Lone Oak Rd
Ste 245
Paducah, KY 42003
Phone (270) 538-5537

1532 Lone Oak Rd
Ste 415
Paducah, KY 42003

1532 Lone Oak Rd
Ste 320
Paducah, KY 42003
Phone (270) 415-3830

1530 Lone Oak Rd
Paducah, KY 42003
Phone (270) 444-2444

Organizations & group practices 4

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 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": "1156723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1780792937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 636961",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452636961",
            "telephone_number": "513-981-5130",
            "fax_number": "513-980-5015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1532 LONE OAK RD",
            "address_2": "SUITE 415",
            "city": "PADUCAH",
            "state": "KY",
            "postal_code": "420037913",
            "telephone_number": "270-442-0103",
            "fax_number": "270-442-0109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOSS",
        "first_name": "TERESA",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-28",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3002156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78001799",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "P00947901",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Paducah, KY

Sources for this page

Verify at the official NPI Registry.