Individual provider Active NPI

Christy L Moore, NP

  • Family Nurse Practitioner
  • Kingsport, TN
National Provider Identifier
1821705575
Registry record updated Jun 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
32726 Issued in TN
Practice address
106 Ferrell Ave Ste 5
Kingsport, TN 37663-2371
Phone
(423) 239-0099
Fax
(423) 239-0273
NPI assigned
Nov 2, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2023

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 32726 TN Primary

Addresses

Primary practice location

106 Ferrell Ave Ste 5
Kingsport, TN 37663-2371

Mailing address

106 Ferrell Ave Ste 5
Kingsport, TN 37663-2371
Phone (423) 239-0099

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20230303002316 TN Practitioner - Nurse Practitioner 4183647977 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ipc Pac Healthcare Services of Tennessee PCGroup PAC ID 0840587572, 74 clinicians
NV Pacs 2 LLCGroup PAC ID 0941550578, 119 clinicians

Practice addresses (Care Compare)

2012 Sherwood Dr
Johnson City, TN 37601-3238
Phone (423) 928-3168

505 N Roan St
Johnson City, TN 37601-4740
Phone (423) 975-2000

880 S Mohawk Dr
Erwin, TN 37650-2125
Phone (423) 743-7669

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Johnson City, TN, CCN 447422
  • Greeneville Community Hospital Hospital, Greeneville, TN, CCN 440050

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32726TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Medical Services, PLLC Family CurrentSince Nov 6, 2022 Accepting new patients
NV Pacs 2 LLC CurrentSince Feb 13, 2023 Accepting new patients
CS Pacs 3 Southeast, LLC CurrentSince Sep 14, 2024 Accepting new patients
Ipc Pac Healthcare Services of Tennessee PC CurrentSince Feb 13, 2023 Accepting new patients

Locations

880 S Mohawk Dr
Erwin, TN 37650
Phone (423) 743-7669

106 Ferrell Ave
Ste 5
Kingsport, TN 37663
Phone (423) 239-0099

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": "1667347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1821705575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FERRELL AVE STE 5",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632371",
            "telephone_number": "423-239-0099",
            "fax_number": "423-239-0273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FERRELL AVE STE 5",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376632371",
            "telephone_number": "423-239-0099",
            "fax_number": "423-239-0273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "CHRISTY",
        "middle_name": "L",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-02",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "32726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsport, TN

Sources for this page

Verify at the official NPI Registry.