Mary Patricia Moore, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

2007-01142 Issued in NC

Practice address

280 Broad St Ste E
Kernersville, NC 27284-2948

Phone

(336) 277-6050

Fax

(336) 992-3141

NPI assigned

Nov 13, 2007

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Interoperability endpoints

• Direct secure messaging: mmoore240369@direct.novanthealth.org

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1861672347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE E",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BROAD ST STE E",
            "city": "KERNERSVILLE",
            "state": "NC",
            "postal_code": "272842948",
            "telephone_number": "336-277-6050",
            "fax_number": "336-992-3141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOORE",
        "first_name": "MARY",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2020-10-25",
        "certification_date": "2020-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "2007-01142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmoore240369@direct.novanthealth.org",
            "affiliation": "N",
            "address_1": "280 Broad St Ste E",
            "city": "Kernersville",
            "state": "NC",
            "country_code": "US",
            "postal_code": "272842948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawanna Nicole Moore-Geter, LCMHC
• Amber Moore, LCAS, SAP
• Jeremy Moore
• Lisa Tingen Moore, NP
• Lynn Chorey Moore Sr., PHARMD
• Megan Moore
• Octavia Moore
• Slade Curtis Moore, M.D.
• Carina Moreno Ordonez
• Christina Morgan

• Psychiatry Physician in Kernersville, NC
• Providers in Kernersville, NC by specialty
• Psychiatry Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2020; 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.