Tina L. Moore, APRN, BC-FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

141409 Issued in MO

Practice address

1008 N Main St
Sikeston, MO 63801-5044

Phone

(573) 472-6001

NPI assigned

Sep 29, 2006

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

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tina.moore.1@33202.direct.athenahealth.com
• Direct secure messaging: ms_tmoor204@landmarkhealth-direct.org

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.

• Missouri Delta Medical Center

  • Internal Medicine Physician
  • Sikeston, MO
  • NPI 1508967860
  Medicare reassignment NPD
• Missouri Delta Medical Center

  • Community/Retail Pharmacy
  • Malden, MO
  • NPI 1578371621
  NPD

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1851483523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 MAIN ST",
            "city": "NEW MADRID",
            "state": "MO",
            "postal_code": "638691513",
            "telephone_number": "573-748-2546",
            "fax_number": "573-472-7433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-472-6001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "TINA",
        "middle_name": "L.",
        "credential": "APRN, BC-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-29",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "141409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Missouri Delta Radiology Group, Inc.
• Angeles Fernandez Mojica, PT
• Paul F. Montany, MD
• Caitlyn Marie Moore, MCD, CF-SLP
• Lindsay Moore, PLPC
• James Jeremiah Mooty, FNP
• Brad Morgan, PTA
• Helen Morrill, PMHNP
• Allegra Anne Morris I
• Mosaic Community Services, LLC

• Family Nurse Practitioner in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.