Illaria C Moore, NP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

NP-1326A Issued in ID

Practice address

11050 Montana Ave
Boise, ID 83713-5049

Phone

(208) 954-6783

NPI assigned

Aug 31, 2013

Last updated

Aug 31, 2013By 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 2

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1377907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377907200000",
    "number": "1790119238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11050 MONTANA AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135049",
            "telephone_number": "208-954-6783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11050 MONTANA AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837135049",
            "telephone_number": "208-954-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "ILLARIA",
        "middle_name": "C",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-31",
        "last_updated": "2013-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "ID",
            "license": "NP-1326A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "NP-1326A",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NURSE PRACTITIONER CERTIFICATION",
            "identifier": "AG0613029",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily Moore, PA-C
• Emily Theresa Moore, NURSE PRACTITIONER
• Erin Moore, RRT
• Gary L Moore, LCSW
• Harold Guy Moore, MD
• Jaclyn Moore, LCPC
• Jedd Moore, NP
• Joan Moore, MS, GC
• Katherine McEntee Moore, MED CCC-SLP
• Keith Michael Moore, LPC

• Adult Health Nurse Practitioner in Boise, ID
• Providers in Boise, ID by specialty
• Adult Health Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2013; 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.

Verify at the official NPI Registry.