Nastassja R Moore, N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

17742 Issued in TN

Practice address

2341 McCallie Ave Ste 403
Chattanooga, TN 37404

Phone

(423) 602-9674

Fax

(423) 602-9690

NPI assigned

Jun 25, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528329600000",
    "number": "1841639762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE STE 403",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374043227",
            "telephone_number": "423-602-9674",
            "fax_number": "423-602-9690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2341 MCCALLIE AVE STE 403",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "37404",
            "telephone_number": "423-602-9674",
            "fax_number": "423-602-9690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3905 Webb Rd",
            "address_purpose": "LOCATION",
            "city": "Chattanooga",
            "state": "TN",
            "postal_code": "374161839",
            "country_code": "US",
            "telephone_number": "423-521-4776",
            "fax_number": "423-521-4781",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOORE",
        "first_name": "NASTASSJA",
        "middle_name": "R",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-25",
        "last_updated": "2018-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "161491",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "17742",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q000920",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003136096A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsey Merkle Moore, MD
• Lisa Rainey Moore, M.ED.
• Mary Moore
• Megan Moore, CCC-SLP
• Megan Elizabeth Moore, FNP-BC
• Nickole Renea Moore, LMFT
• Nora Elizabeth Moore, LPE
• Philip Moore, PT, DPT
• Richard A Moore, PHD, M.D.
• Robin Lee Moore, RN

• Family Nurse Practitioner in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.