Individual provider Active NPI

Stephanie Susan Rayl-Moore

  • Family Nurse Practitioner
  • Decatur, AL
National Provider Identifier
1831696806
Registry record updated Jun 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F12 Issued in AL
Practice address
2828 Highway 31 S
Decatur, AL 35603-1538
Phone
(256) 353-2000
NPI assigned
Apr 6, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2021

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 F12 AL Primary

Addresses

Primary practice location

2828 Highway 31 S
Decatur, AL 35603-1538

Mailing address

30 Burton Hills Blvd
Ste 175
Nashville, TN 37215-6403
Phone (615) 988-2014

Other identifiers 1

IdentifierTypeStateIssuer
1-138771OtherALSTATE LICENSE

Other names 1

  • Stephanie Susan Rayl Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20180822002259 AL Practitioner - Nurse Practitioner 4385993443 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advantage Family Care IncGroup PAC ID 7618103748, 56 clinicians

Practice addresses (Care Compare)

1311 2ND Ave SW
Suite a
Cullman, AL 35055-5308
Phone (256) 841-3622

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F12ALMDFamily Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1522972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1831696806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 BURTON HILLS BLVD",
            "address_2": "STE 175",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156403",
            "telephone_number": "615-988-2014",
            "fax_number": "615-208-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2828 HIGHWAY 31 S",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031538",
            "telephone_number": "256-353-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYL-MOORE",
        "first_name": "STEPHANIE",
        "middle_name": "SUSAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-06",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "F12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "1-138771",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "STEPHANIE",
            "last_name": "RAYL",
            "middle_name": "SUSAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Decatur, AL

Sources for this page

Verify at the official NPI Registry.