Individual provider Active NPI

Susan Ashley Moore, NP

  • Nurse Practitioner
  • Charlotte, NC
National Provider Identifier
1811004641
Registry record updated Jul 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
900442 Issued in NC
Practice address
1237 Harding PL
Ste 3100
Charlotte, NC 28204
Phone
(704) 373-0212
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X 900442 NC
Gerontology Nurse Practitioner 363LG0600X 900442 NC
Nurse Practitioner 363L00000X 900442 NC Primary

Addresses

Primary practice location

1237 Harding PL
Ste 3100
Charlotte, NC 28204

Mailing address

PO Box 19305
Charlotte, NC 28219-9305

Other practice location 1

10650 Park Rd
Charlotte, NC 28210-8538
Phone (704) 667-3840

Other practice location 2

101 E W T Harris Blvd
Ste 1213
Charlotte, NC 28262-3485
Phone (704) 863-1950

Other practice location 3

1237 Harding Pl
Ste 4100
Charlotte, NC 28204
Phone (704) 355-8816

Electronic endpoints 2

TypeEndpointUseAffiliation
CONNECT URL https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other ABILITY Network
Direct Messaging Address smoore137293@CarolinasHealthcareSystem.direct-ci.com Atrium Health

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040818001096 NC Practitioner - Nurse Practitioner 6608849435 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Carolinas Physicians Network IncGroup PAC ID 3375449655, 2,324 clinicians

Practice addresses (Care Compare)

1000 Blythe Blvd
Charlotte, NC 28203-5812
Phone (704) 355-2000

Hospital & facility affiliations

  • Carolinas Medical Center/Behav Health Hospital, Charlotte, NC, CCN 340113

Merit-based Incentive Payment System (MIPS)

Final score
94 of 100Reported as apm
Quality
81.63
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
900442NCMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Carolinas Physicians Network Inc CurrentSince May 21, 2012 Accepting new patients
Carolinas Physicians Network Inc CurrentSince May 21, 2012 Accepting new patients
Carolinas Physicians Network Inc Current Accepting new patients

Locations

100 N 6th St
Ste 900A
Minneapolis, MN 55403

1237 Harding Pl
Ste 4100
Charlotte, NC 28204
Phone (704) 355-8816

10650 Park Rd
Charlotte, NC 28210
Phone (704) 667-0337

1237 Harding Pl
Ste 3100
Charlotte, NC 28204

1001 Blythe Blvd
Ste 300
Charlotte, NC 28203

101 E Wt Harris Blvd
Ste 1213
Charlotte, NC 28262
Phone (704) 863-1950

1000 Blythe Blvd
Charlotte, NC 28203
Phone (704) 351-3791

990 Lee Ann Dr NE
Concord, NC 28025
Phone (704) 441-0272

134 Medical Park Rd
Ste 111
Mooresville, NC 28117
Phone (704) 801-9100

Interoperability endpoints

  • Direct secure messaging: smoore137293@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1811004641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19305",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282199305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 HARDING PL",
            "address_2": "STE 3100",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "28204",
            "telephone_number": "704-373-0212"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10650 Park Rd",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108538",
            "country_code": "US",
            "telephone_number": "704-667-3840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 E W T Harris Blvd",
            "address_2": "Ste 1213",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623485",
            "country_code": "US",
            "telephone_number": "704-863-1950",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 4100",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28204",
            "country_code": "US",
            "telephone_number": "704-355-8816",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "SUSAN",
        "middle_name": "ASHLEY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NC",
            "license": "900442",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "NC",
            "license": "900442",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NC",
            "license": "900442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.667.2",
            "affiliationName": "ABILITY Network",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "100 N 6th St Ste 900A",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554031516",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smoore137293@CarolinasHealthcareSystem.direct-ci.com",
            "affiliation": "Y",
            "affiliationName": "Atrium Health",
            "address_1": "1237 Harding Pl",
            "address_2": "Ste 3100",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282042826",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.